Evidence map›Paper›PMID 42782013›Full record

ArticleJACC. Advances2026

Mitral Regurgitation after TAVR: Sex Differences and Low-Flow Low-Gradient Aortic Stenosis.

Eric D Warner, Serge Harb, Rhonda Miyasaka, Rishi Puri, Amar Krishnaswamy, Samir R Kapadia, Grant W Reed

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Article in JACC. Advances, 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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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Eric D WarnerHeart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Serge HarbHeart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Rhonda MiyasakaHeart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Rishi PuriHeart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Amar KrishnaswamyHeart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Samir R KapadiaHeart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Grant W ReedHeart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: Reedg2@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundModerate or severe mitral regurgitation (MR) is common in patients with severe aortic stenosis (AS) treated with transcatheter aortic valve replacement (TAVR).

objectivesThe objectives of the study was to help define the prevalence and prognosis of persistent MR post-TAVR, particularly in women and in low-flow low-gradient (LFLG) AS.

methodsIn this single-center, observational study, 344 consecutive TAVR patients with severe AS and moderate or greater MR pre-TAVR were identified. Patients were stratified by AS subtype (classic vs LFLG). Factors associated with MR improvement to mild or less were evaluated using multivariable logistic regression. Survival was analyzed with Cox proportional hazards models adjusted for clinical and echocardiographic covariates.

resultsThe mean age was 81.9 years, 48.5% were females, and 45.1% had LFLG AS. MR improved by ≥1 grade in 62.8% and to mild or less in 52.9% of patients, with similar rates in classic vs LFLG AS. On multivariable analysis, severe (vs moderate) baseline MR, hypertension, and female sex were independently associated with lower odds of MR improvement to mild or less. In LFLG AS, female sex and severe MR remained significant predictors of persistent MR, whereas a higher pre-TAVR aortic valve mean gradient was associated with improved MR. Residual severe MR was associated with increased mortality, driven by those with LFLG AS.

conclusionsMore than half of TAVR patients with moderate or severe MR experience MR improvement post-TAVR. Women and those with severe MR are less likely to have a significant improvement in MR. Patients with LFLG AS and persistent moderate or severe MR have worse survival post-TAVR.

Indexed as

low-flow low-gradient aortic stenosismitral regurgitationsex differencestranscatheter aortic valve replacementvalvular heart disease

Identifiers

PMID42782013
PMCPMC13616514

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