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Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure

Background: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has e...

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Detalles Bibliográficos
Autores principales: Trejo-Velasco, Blanca, Estevez-Loureiro, Rodrigo, Carrasco-Chinchilla, Fernando, Fernández-Vázquez, Felipe, Arzamendi, Dabit, Pan, Manuel, Pascual, Isaac, Nombela-Franco, Luis, Amat-Santos, Ignacio J., Freixa, Xavier, Hernández-Antolín, Rosa Ana, Trillo-Nouche, Ramiro, Andraka Ikazuriaga, Leire, López-Mínguez, José R., Sanmiguel Cervera, Dario, Sanchis, Juan, Diez-Gil, José Luis, Ruiz-Quevedo, Valeriano, Urbano-Carrillo, Cristóbal, Becerra-Muñoz, Víctor Manuel, Benito-González, Tomás, Li, Chi Hion, Mesa, Dolores, Avanzas, Pablo, Armijo, Germán, Serrador-Frutos, Ana María, Sanchis, Laura, Lobán, Covadonga Fernández-Golfín, Cid-Álvarez, Belén, Hernández-García, José María, Garrote-Coloma, Carmen, Fernández-Peregrina, Estefanía, Romero, Miguel, León Arguero, Víctor, Cruz-González, Ignacio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958333/
https://www.ncbi.nlm.nih.gov/pubmed/33801311
http://dx.doi.org/10.3390/jcm10051006
Descripción
Sumario:Background: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has emerged as a relevant prognostic predictor in HF. In this study, we aimed to assess the prognostic value of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP) ratio as a non-invasive measure of RV-to-PA coupling in patients undergoing TMVR with MitraClip (Abbott, CA, USA). Methods: Multicentre registry including 228 consecutive patients that underwent successful TMVR with MitraClip. The sample was divided in two groups according to TAPSE/PASP median value: 0.35. The primary combined endpoint encompassed HF readmissions and all-cause mortality. Results: Mean age was 72.5 ± 11.5 years and 154 (67.5%) patients were male. HF readmissions and all-cause mortality were more frequent in patients with TAPSE/PASP ≤ 0.35: Log-Rank 8.844, p = 0.003. On Cox regression, TAPSE/PASP emerged as a prognostic predictor of the primary combined endpoint, together with STS-Score. TAPSE/PASP was a better prognostic predictor than either TAPSE or PASP separately. Conclusions: TAPSE/PASP ratio appears as a novel prognostic predictor in patients undergoing MitraClip implantation that might improve risk stratification and candidate selection.