Rottländer Dennis, Hausleiter Jörg, Schmitz Thomas, Bufe Alexander, Seyfarth Melchior, von Bardeleben Ralph Stephan, Beucher Harald, Ouarrak Taoufik, Schneider Steffen, Boekstegers Peter
Department of Cardiology, Faculty of Health, School of Medicine, Witten, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany.
Department of Cardiology, Krankenhaus Porz Am Rhein, Cologne, Germany.
Clin Res Cardiol. 2024 Dec 9. doi: 10.1007/s00392-024-02580-6.
The MITRA-PRO registry revealed residual mitral regurgitation (MR) to be an important predictor of survival following transcatheter edge-to-edge repair (TEER). Intraprocedural MR assessment using 3D-Vena Contracta Area (VCA) might be a feasible tool to guide mitral TEER procedures. The study aimed to assess the impact of residual MR assessed by 3D-VCA on 1-year mortality.
823 patients with residual MR quantification using 3D-VCA in the MITRA-PRO registry, were included in this study. 1-year mortality, NYHA classification and major adverse events were assessed 1-year after mitral TEER.
Patients with trace residual MR after mitral TEER were allocated to the 3D-VCA < 0.1 cm group (27.8%), while a 3D-VCA ≥ 0.1 < 0.3 cm (55.4%) was considered as mild and a 3D-VCA ≥ 0.3 cm (16.8%) as relevant residual MR. One-year mortality was significantly lower in patients with non-relevant residual MR (3D-VCA < 0.1 cm: 10.5%; ≥ 0.1 < 0.3 cm: 16.0%; ≥ 0.3: 24.8%, p = 0.003). An increasing 3D-VCA post mitral TEER was associated with a higher 1-year mortality. At a 3D-VCA of 0.07 cm mortality increased significantly (1-year mortality 3D-VCA post mitral TEER ≥ 0.07 cm: 16.5% vs. < 0.07 cm: 7.8%; p = 0.005) indicating a 3D-VCA of 0.07 cm to be a cut-off value for survival in daily practice.
Residual MR assessed by 3D-VCA after TEER is associated with 1-year mortality. Therefore, 3D-VCA is a valuable echocardiographic tool for intraprocedural MR assessment during mitral TEER and achieving a lower 3D-VCA improve patient survival. (German Clinical Trials Register: DRKS00012288).
DRKS00012288.
MITRA - PRO注册研究显示，残余二尖瓣反流（MR）是经导管缘对缘修复术（TEER）后生存的重要预测指标。使用三维缩流颈面积（VCA）进行术中MR评估可能是指导二尖瓣TEER手术的可行工具。本研究旨在评估通过三维VCA评估的残余MR对1年死亡率的影响。
本研究纳入了MITRA - PRO注册研究中823例使用三维VCA进行残余MR量化的患者。二尖瓣TEER术后1年评估1年死亡率、纽约心脏协会（NYHA）分级和主要不良事件。
二尖瓣TEER术后微量残余MR的患者被分配到三维VCA＜0.1 cm组（27.8%），而三维VCA≥0.1＜0.3 cm（55.4%）被视为轻度，三维VCA≥0.3 cm（16.8%）被视为有意义的残余MR。无意义残余MR的患者1年死亡率显著较低（三维VCA＜0.1 cm：10.5%；≥0.1＜0.3 cm：16.0%；≥0.3：24.8%，p = 0.003）。二尖瓣TEER术后三维VCA增加与1年死亡率升高相关。在三维VCA为0.07 cm时，死亡率显著增加（二尖瓣TEER术后三维VCA≥0.07 cm时1年死亡率：16.5% vs.＜0.07 cm时：7.8%；p = 0.005），表明三维VCA为0.07 cm是日常实践中生存的临界值。
TEER术后通过三维VCA评估的残余MR与1年死亡率相关。因此，三维VCA是二尖瓣TEER术中MR评估的有价值的超声心动图工具，降低三维VCA可提高患者生存率。（德国临床试验注册中心：DRKS00012288）。
DRKS00012288。
