Observational studyJACC. Cardiovascular interventions2024
Impact of Intraprocedural Mitral Regurgitation and Gradient Following Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation.
Observational study in JACC. Cardiovascular interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Functional mitral valve regurgitation outcomes by treatment modality: a systematic review and meta-analysis of reconstructed survival data.BMC cardiovascular disorders · 2026Pooled it
- Clinical Failure After Mitral Transcatheter Edge-to-Edge Repair Mechanisms, Outcomes, and Management.Structural heart : the journal of the Heart Team · 2026Review
- Challenging the limits of mitral-TEER: a PASCAL case in the anatomical 'red zone': a case report.European heart journal. Case reports · 2026Article
- 2025 ESC/EACTS valvular heart disease guidelines: practical updates on mitral and tricuspid regurgitation.European heart journal supplements : journal of the European Society of Cardiology · 2026Article
- Residual left atrial v wave predicts clinical outcome of transcatheter edge-to-edge mitral valve repair.ESC heart failure · 2026Observational
- Impact of residual moderate mitral regurgitation after transcatheter edge-to-edge repair on long-term survival: insights from a multicenter cohort study.Frontiers in cardiovascular medicine · 2026Article
- Echocardiographic and invasive RV-PA coupling predict mortality after edge-to-edge repair for degenerative mitral regurgitation, while pulmonary artery pulsatility index does not: a single-center observational study.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Prognostic value of NT-proBNP in patients with primary mitral regurgitation undergoing transcatheter edge-to-edge repair.European journal of heart failure · 2025Article
- Characterization of Patients Unsuited for Transcatheter Mitral Valve Interventions.Journal of clinical medicine · 2025Article
- Cardiac Rehabilitation After Mitral Valve Intervention: Tailored Assessment, Management, and Exercise Training.Journal of cardiovascular development and disease · 2025Review
- [Short-term clinical efficacy of transcatheter edge-to-edge repair for moderate to severe mitral regurgitation].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2025Article
- Intraprocedural mitral regurgitation and gradient: key determinants of transcatheter edge-to-edge repair outcomes for primary mitral regurgitation.Cardiovascular diagnosis and therapy · 2025Article
- Mitral valve edge-to-edge repair under scrutiny: what can we learn from transoesophageal echocardiographic follow-up?EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Article
- The pivotal role of echocardiography in structural heart interventions: from planning to success.Therapeutic advances in cardiovascular diseaseReview
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Authors and funding
43 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of intraprocedural results following transcatheter edge-to-edge repair (TEER) in primary mitral regurgitation (MR) is controversial.
objectivesThis study sought to investigate the prognostic impact of intraprocedural residual mitral regurgitation (rMR) and mean mitral valve gradient (MPG) in patients with primary MR undergoing TEER.
methodsThe PRIME-MR (Outcomes of Patients Treated With Mitral Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation) registry included consecutive patients with primary MR undergoing TEER from 2008 to 2022 at 27 international sites. Clinical outcomes were assessed according to intraprocedural rMR and mean MPG. Patients were categorized according to rMR (optimal result: ≤1+, suboptimal result: ≥2+) and MPG (low gradient: ≤5 mm Hg, high gradient: > 5 mm Hg). The prognostic impact of rMR and MPG was evaluated in a Cox regression analysis. The primary endpoint was 2-year all-cause mortality or heart failure hospitalization.
resultsIntraprocedural rMR and mean MPG were available in 1,509 patients (median age = 82 years [Q1-Q3: 76.0-86.0 years], 55.1% male). Kaplan-Meier analysis according to rMR severity showed significant differences for the primary endpoint between rMR ≤1+ (29.1%), 2+ (41.7%), and ≥3+ (58.0%; P < 0.001), whereas there was no difference between patients with a low (32.4%) and high gradient (42.1%; P = 0.12). An optimal result/low gradient was achieved in most patients (n = 1,039). The worst outcomes were observed in patients with a suboptimal result/high gradient. After adjustment, rMR ≥2+ was independently linked to the primary endpoint (HR: 1.87; 95% CI: 1.32-2.65; P < 0.001), whereas MPG >5 mm Hg was not (HR: 0.78; 95% CI: 0.47-1.31; P = 0.35).
conclusionsIntraprocedural rMR but not MPG independently predicted clinical outcomes following TEER for primary MR. When performing TEER in primary MR, optimal MR reduction seems to outweigh the impact of high transvalvular gradients.
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