Impact of right ventricular-to-pulmonary artery coupling on remodeling and outcome in patients undergoing transcatheter edge-to-edge mitral valve repair Article Swipe
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· 2023
· Open Access
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· DOI: https://doi.org/10.1007/s00392-023-02318-w
Background Right ventricular-to-pulmonary artery (RV–PA) coupling has recently been shown to be associated with outcome in valvular heart disease. However, longitudinal data on RV dysfunction and reverse cardiac remodeling in patients following transcatheter edge-to-edge mitral valve repair (M-TEER) are scarce. Methods Consecutive patients with primary as well as secondary mitral regurgitation (MR) were prospectively enrolled and had comprehensive echocardiographic and invasive hemodynamic assessment at baseline. Kaplan–Meier estimates and multivariable Cox-regression analyses were performed, using a composite endpoint of heart failure hospitalization and death. Results Between April 2018 and January 2021, 156 patients (median 78 y/o, 55% female, EuroSCORE II: 6.9%) underwent M-TEER. On presentation, 64% showed impaired RV–PA coupling defined as tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) ratio < 0.36. Event-free survival rates at 2 years were significantly lower among patients with impaired coupling (57 vs. 82%, p < 0.001), both in patients with primary (64 vs. 91%, p = 0.009) and secondary MR (54 vs. 76%, p = 0.026). On multivariable Cox-regression analyses adjusted for baseline, imaging, hemodynamic, and procedural data, TAPSE/PASP ratio < 0.36 was independently associated with outcome (adj.HR 2.74, 95% CI 1.17–6.43, p = 0.021). At 1-year follow-up, RV–PA coupling improved (TAPSE: ∆ + 3 mm, PASP: ∆ − 10 mmHg, p for both < 0.001), alongside with a reduction in tricuspid regurgitation (TR) severity (grade ≥ II: 77–54%, p < 0.001). Conclusions TAPSE/PASP ratio was associated with outcome in patients undergoing M-TEER for primary as well as secondary MR. RV–PA coupling, alongside with TR severity, improved after M-TEER and might thus provide prognostic information in addition to established markers of poor outcome. Graphical abstract
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1007/s00392-023-02318-w
- https://link.springer.com/content/pdf/10.1007/s00392-023-02318-w.pdf
- OA Status
- hybrid
- Cited By
- 11
- References
- 25
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4387865424
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4387865424Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1007/s00392-023-02318-wDigital Object Identifier
- Title
-
Impact of right ventricular-to-pulmonary artery coupling on remodeling and outcome in patients undergoing transcatheter edge-to-edge mitral valve repairWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-10-23Full publication date if available
- Authors
-
Matthias Koschutnik, Carolina Donà, Christian Nitsche, Andreas A. Kammerlander, Varius Dannenberg, Christina Brunner, Sophia Koschatko, Katharina Mascherbauer, Gregor Heitzinger, Kseniya Halavina, Georg Spinka, Max‐Paul Winter, Martin Hülsmann, Philipp E. Bartko, Christian Hengstenberg, Julia Mascherbauer, Georg GoliaschList of authors in order
- Landing page
-
https://doi.org/10.1007/s00392-023-02318-wPublisher landing page
- PDF URL
-
https://link.springer.com/content/pdf/10.1007/s00392-023-02318-w.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
-
https://link.springer.com/content/pdf/10.1007/s00392-023-02318-w.pdfDirect OA link when available
- Concepts
-
Medicine, Cardiology, Internal medicine, Pulmonary artery, Heart failure, Hemodynamics, Pulmonary hypertension, Ventricular remodeling, Mitral regurgitation, Hazard ratio, Clinical endpoint, Proportional hazards model, Mitral valve repair, Tricuspid valve, Confidence interval, Clinical trialTop concepts (fields/topics) attached by OpenAlex
- Cited by
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11Total citation count in OpenAlex
- Citations by year (recent)
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2025: 6, 2024: 5Per-year citation counts (last 5 years)
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25Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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