Evidence map›Paper›PMID 38351672›Full record

ArticleESC heart failure2024

Guideline-directed medical therapy assessment in heart failure patients undergoing percutaneous mitral valve repair.

Karl-Patrik Kresoja, Marianna Adamo, Karl-Phillipp Rommel, Lukas Stolz, Nicole Karam, Cristina Giannini, Bruno Melica, Ralph Stephan von Bardeleben, Christian Butter, Patrick Horn and 7 more

2 registry-linked trialsAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07578129 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Improvement in Guideline-Directed Medical Therapy After Tricuspid Transcatheter Edge-to-Edge Repair in Participants With Reduced Left Ventricular Function

Typeobservational_patient_registrySponsorCeric SàrlRan2026 to 2027Enrolled50ConditionsTricuspid Insufficiency, Tricuspid Regurgitation (TR), Left Ventricular Cardiac Dysfunction, Left Ventricular (LV) Systolic Dysfunction
NCT07758023 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Achieving Optimal Medical Therapy Through Percutaneous Treatment of Secondary Mitral Regurgitation to Improve Outcome in Patients With HFrEF

TypeinterventionalSponsorUniversity Medical Center MainzRan2026 to 2030Enrolled520ConditionsMitral Regurgitation Functional, Heart Failure With Reduced Ejection Fraction (HFrEF)ArmsM-TEER, Standardized GDMT Up-Titration
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. Review
  5. Review
  6. Review
  7. High-intensity care for GDMT titration.Heart failure reviews · 2024
    Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Karl-Patrik KresojaDepartment of Cardiology, University Medical Center of Mainz, Mainz, Germany.ORCID https://orcid.org/0000-0002-8616-6751
Marianna AdamoCardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Karl-Phillipp RommelDepartment of Cardiology, University Medical Center of Mainz, Mainz, Germany.
Lukas StolzMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany.
Nicole KaramDepartment of Cardiology, European Hospital Georges Pompidou and Paris Cardiovascular Research Center, INSERM U970, Paris, France.
Cristina GianniniCardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Bruno MelicaCentro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
Ralph Stephan von BardelebenDepartment of Cardiology, University Medical Center of Mainz, Mainz, Germany.
Christian ButterDepartment of Cardiology, Immanuel Heart Center Bernau, Brandenburg Medical School Theodor Fontane, Bernau, Germany.
Patrick HornDepartment of Cardiology, Heart Center, University Hospital of Düsseldorf, Düsseldorf, Germany.
Fabien PrazUniversitätsklinik für Kardiologie, Inselspital Bern, Bern, Switzerland.
Daniel KalbacherDepartment of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.
Christos IliadisDepartment of Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany.
Holger ThieleDepartment of Cardiology, University Medical Center of Mainz, Mainz, Germany.
Jörg HausleiterMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany.
Marco MetraCardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Philipp LurzDepartment of Cardiology, University Medical Center of Mainz, Mainz, Germany.

Funding

University Medical Center Mainz of the Johannes Gutenberg University Mainz
6 · The paper itself

Abstract

aimsAchieving optimized guideline-directed medical therapy (GDMT) is recommended prior to transcatheter mitral valve edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR). We aimed to propose and validate an easy-to-use score for assessing the quality of GDMT in patients with heart failure with reduced ejection fraction (HFrEF) undergoing M-TEER. METHODS AND

resultsAmong the 1641 EuroSMR patients enrolled in the EuroSMR Registry who underwent M-TEER, a total of 1072 patients [median age 74, interquartile range (IQR) 67-79 years, 29% female] had complete data on GDMT and a left ventricular ejection fraction ≤ 40% and were included in the current study. We proposed a GDMT score that considers the dosage levels of three medication classes (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors, beta-blockers, and mineralocorticoid receptor antagonists), with a maximum score of 12 points indicating optimal GDMT. The primary outcome was all-cause mortality. The median GDMT score was 4 points (IQR 3-6). All three domains of the scoring system were associated with all-cause mortality (P < 0.05 for all). The overall GDMT score was associated with all-cause mortality (hazard ratio 0.90, 95% confidence interval 0.86-0.95 for each 1-point increase in the GDMT score). This association remained significant after adjusting for renal function and co-morbidities.

conclusionsThis study demonstrates the utility of a simple GDMT scoring system for assessing the adequacy of GDMT in HFrEF patients with relevant SMR undergoing M-TEER. The GDMT score has potential applications in guiding the design of future clinical trials and aiding clinical decision-making processes.

Indexed as

Heart FailureMitral ValveMitral Valve InsufficiencyStroke VolumeAgedCardiac CatheterizationFemaleFollow-Up StudiesHeart Valve Prosthesis ImplantationHumansMalePractice Guidelines as TopicRegistriesTreatment OutcomeVentricular Function, LeftGuideline‐directed medical therapyHeart failure with reduced ejection fractionMitral regurgitation

Identifiers

PMID38351672
PMCPMC11098622

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.