Impact of pulmonary hypertension on short and long-term outcome after mitral transcatheter edge-to-edge repair: A meta-analysis.

BACKGROUND

Pulmonary hypertension (pHTN) has been associated with increased morbidity and mortality after mitral Transcatheter Edge-to-Edge Repair (TEER), but the association remains uncertain. This study aims to evaluate the impact of pHTN on cardiovascular outcomes following TEER.

METHODS

We searched PubMed, Scopus, and Medline to identify studies reporting outcomes after TEER in individuals with pHTN. Utilizing a random-effects model, we ascertained a pooled odds ratio (OR) of clinical outcomes in patients with pulmonary artery systolic pressure (PASP >50 mmHg) vs. without (PASP <50 mmHg) severe pHTN.

RESULTS

We included seven studies with 27,965 patients. The mean age was 79.9 (±5.2) years; 53 % were male, and 75 % were New York Heart Association (NYHA) class-III/IV with a median follow-up of 360 days. Patients with severe pHTN had higher odds of in-hospital all-cause mortality (OR: 1.99, 95 % CI: 1.69-2.34, p < 0.00001) and Major adverse cardiovascular events (MACE) (OR: 1.38, 95 % CI: 1.22-1.56, p < 0.00001) compared to patients without severe pHTN.

CONCLUSIONS

Severe pHTN is associated with increased risks of all-cause mortality, MACE, and higher heart failure rehospitalizations in patients undergoing mitral TEER. Prospective trials are necessary to validate the findings and determine if early intervention improves clinical outcomes.