ArticleCardiovascular diagnosis and therapy2026
Prediction of long-term survival in patients with concomitant pulmonary hypertension and its subtypes after successful transcatheter edge-to-edge mitral valve repair.
Article in Cardiovascular diagnosis and therapy, 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
Background: Pulmonary hypertension (PH) is a comorbidity closely associated with high-grade mitral valve regurgitation (MR), for which transcatheter edge-to-edge mitral valve repair (M-TEER) is a valuable treatment method. To date, conflicting evidence exists regarding the impact of PH on treatment outcomes due to divergent PH definitions between studies and the updated guideline definitions. This study aimed to investigate the prevalence of PH and its respective subtypes and their impact on long-term survival after M-TEER. Methods: In this monocentric cohort study, all patients who underwent M-TEER and provided right heart catheterization (RHC) data were analyzed. PH and its respective subtypes were defined according to the current guidelines. Differences in long-term survival were analyzed using the Kaplan-Meier method, and independent predictors of mortality were analyzed using uni- and multivariable Cox regression analyses. Results: A total of 183 patients underwent M-TEER, but 58 patients had to be excluded from further analysis due to insufficient hemodynamic recordings. Among the included patients, 77.6% (97/125) revealed concomitant PH. Combined post- and precapillary PH (Cpc-PH) was the most common subtype in 56.7% (55/97) of patients. This subtype was associated with significantly greater morbidity compared with isolated postcapillary PH (Ipc-PH), which was the second most common subtype, observed in 39.2% (38/97) of the patients. Long-term survival significantly deteriorated in PH patients, while Ipc-PH patients presented a nonsignificant trend towards better survival compared to those with Cpc-PH. Although there was a significant correlation between noninvasive and invasive measurements of pulmonary artery systolic pressure (PASP) among Cpc-PH patients, PASP was significantly underestimated by noninvasive measurements in both PH cohorts. Conclusions: The early differentiation of patients undergoing M-TEER with respect to PH and its complicating comorbidities could represent a potential approach to improve long-term outcomes. Invasive RHC measurements remain crucial for classifying PH subgroups and their underlying PASP.
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