Abstract
Background: The prognostic significance of intraprocedural pulsed-wave Doppler analysis of pulmonary venous flow (PVF) during mitral transcatheter edge-to-edge repair (TEER) remains understudied. We aimed to investigate the prognostic value of systolic dominant-PVF (SD-PVF) morphology post-TEER. Methods: In a retrospective analysis from December 2019 to December 2022, patients undergoing mitral TEER were categorized into SD-PVF and systolic blunting (SB)-PVF groups based on post-TEER morphology. The primary endpoint was a composite of all-cause mortality or heart failure hospitalization at 1 year. We investigated the association of PVF morphology post-TEER with the primary endpoint at 1 year using Cox regression and compared the prognostic accuracy of PVF variables through receiver operating characteristic (ROC) curve analysis. Results: Among 187 patients (mean age 76.4 ± 10.5 years, 51.3% primary etiology), residual mitral regurgitation (MR) ≤mild was observed in 147 (82.4%) patients and 105 (56.2%) had SD-PVF post-TEER. Patients with SD-PVF had a lower incidence of >2+ residual MR after clip deployment, at 30 days (2.1% vs. 13.1%; p = 0.005) and at 1 year (1.4% vs. 9%; p = 0.08). SD-PVF post-TEER was independently associated with the primary endpoint (HR = 0.59, 95% CI = 0.39–0.87; p = 0.009). ROC curve analysis of the prognostic accuracy of SD-PVF demonstrated an AUC of 0.64 (95% CI = 0.54–0.73), comparable to other quantitative measures of PVF. Conclusion: Assessing PVF morphology after clip deployment offers a simple prognostic tool for patients undergoing mitral TEER. Multicenter cohorts will be necessary to further investigate its prognostic value.
Original language | English (US) |
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Pages (from-to) | 1027-1036 |
Number of pages | 10 |
Journal | Catheterization and Cardiovascular Interventions |
Volume | 104 |
Issue number | 5 |
DOIs | |
State | Published - Nov 1 2024 |
Keywords
- mitral regurgitation
- mitral transcatheter edge-to-edge repair
- pulmonary venous flow
- Mitral Valve/physiopathology
- Predictive Value of Tests
- Risk Assessment
- Humans
- Risk Factors
- Male
- Treatment Outcome
- Systole
- Echocardiography, Doppler, Pulsed
- Pulmonary Circulation
- Cardiac Catheterization
- Time Factors
- Blood Flow Velocity
- Aged, 80 and over
- Female
- Retrospective Studies
- Aged
- Pulmonary Veins/physiopathology
- Mitral Valve Insufficiency/physiopathology
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine