ArticleBMC cardiovascular disorders2026
Prognostic value of the TAPSE/PASP-ratio in patients with severe mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTranscatheter edge-to-edge mitral valve repair (M-TEER) represents an effective treatment modality for high-grade mitral valve regurgitation. The right ventricle (RV) to pulmonary artery (PA) coupling ratio has been indicated as a marker of right ventricular dysfunction (RVD), but evidence among M-TEER patients remains inconsistent to date due to divergent definitions. We therefore aimed to shed light on the impact of RV-PA uncoupling on survival following M-TEER.
methodsData from all patients who underwent M-TEER and provided sufficient echocardiographic data were investigated. RV-PA uncoupling was defined as the ratio of tricuspid annular pulse systolic excursion (TAPSE) and to the Doppler echocardiographic-derived pulmonary artery systolic pressure (D-PASP) < 0.37 mm/mmHg. The difference in long-term survival between patients with and without RV-PA uncoupling were analyzed via the Kaplan-Meier method, and independent predictors of mortality were identified via uni- and multivariable Cox regression analyses.
resultsA total of 158 patients were eligible for analysis, and RV-PA uncoupling was present in 32.3% of the patients (51/158). Patients with RV-PA uncoupling presented significantly advanced congestive heart failure stages. While M-TEER was performed equally safely in patients with RV-PA uncoupling (odds ratio for procedural success: 0.95, 95% confidence interval [CI] 0.29-2.77, p = 0.9), their long-term survival three years after M-TEER was significantly worse (50.9% (26/51) vs. 61.7% (66/107), p = 0.01). In this regard, a TAPSE/D-PASP ratio < 0.37 mm/mmHg proved to be a more consistent discriminator of long-term survival than a TAPSE < 18 mm alone.
conclusionRV-PA uncoupling, defined as a TAPSE/D-PASP ratio of < 0.37 mm/mmHg, is a feasible and reproducible parameter, which also serves as a marker for advanced congestive heart failure and worse survival outcomes.
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