ArticleClinical research in cardiology : official journal of the German Cardiac Society2022
Impact of asymmetric tethering on outcomes after edge-to-edge mitral valve repair for secondary mitral regurgitation.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The Expanding Therapeutic Armamentarium for Mitral Regurgitation: Surgical and Transcatheter Interventions.Biomedicines · 2026Review
- Echocardiographic Screening for Transcatheter Edge-to-Edge Mitral Valve Repair: Correlation Between Transthoracic and Transesophageal Assessment.Journal of cardiovascular development and disease · 2025Article
- Identifying Responders to Transcatheter Interventions for Secondary Mitral Regurgitation.Current treatment options in cardiovascular medicine · 2025Review
- Relevance of mexiletine in the era of evolving antiarrhythmic therapy of ventricular arrhythmias.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Review
- Ten Future Challenges in the Field of Transcatheter Mitral Valve Edge-to-Edge Repair.Journal of clinical medicine · 2024Review
- Mitral valve transcatheter edge-to-edge repair.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
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13 authors.
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Abstract
backgroundThe impact of postero-anterior and medio-lateral mitral valve (MV) tethering patterns on outcomes in patients undergoing transcatheter edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR) is unknown.
methodsThe ratio of the posterior to anterior MV leaflet angle (PLA/ALA) in MV segment 2 was defined as postero-anterior tethering asymmetry. Medio-lateral tethering asymmetry was assessed as the ratio of the medial (segment 3) to lateral (segment 1) MV tenting area. We used receiver-operating characteristics and a Cox regression model to identify cut-off values of asymmetric anteroposterior and medio-lateral tethering for prediction of 2 year all-cause mortality after TMVR.
resultsAmong 178 SMR patients, postero-anterior tethering was asymmetric in 67 patients (37.9%, PLA/ALA ratio > 1.54). Asymmetric medio-lateral tethering (tenting area ratio > 1.49) was observed in 49 patients (27.5%). M-TEER reduced MR to ≤ 2 + in 92.1% of patients; MR reduction was less effective in the presence of asymmetric postero-anterior tethering (p = 0.02). A multivariable Cox regression model identified both types of asymmetric MV tethering to be associated with increased all-cause 2-year mortality (postero-anterior tethering asymmetry: HR = 2.77, CI 1.43-5.38; medio-lateral tethering asymmetry: HR = 2.90, CI 1.54-5.45; p < 0.01).
conclusionsAsymmetric postero-anterior and medio-lateral MV tethering patterns are associated with increased 2-year mortality in patients undergoing M-TEER for SMR. A detailed echocardiographic analysis of MV anatomy may help to identify patients who profit most from M-TEER.
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