Structural Heart最新文献

{"title":"Persistent Severe Tricuspid Regurgitation After Mitral Transcatheter Edge-to-Edge Repair: Prognostic Implications of Guideline-Based Eligibility for Transcatheter Tricuspid Valve Intervention","authors":"Moritz Kühlein MD,&nbsp;Jule Tervooren,&nbsp;Vera Fortmeier MD,&nbsp;Amelie Hesse,&nbsp;Elena Rippen MD,&nbsp;Michelle Fett,&nbsp;Héctor Alfonso Alvarez Covarrubias MD,&nbsp;Moritz von Scheidt MD,&nbsp;Ferdinand Roski,&nbsp;Muhammed Gerçek MD,&nbsp;Shinsuke Yuasa MD, PhD,&nbsp;N. Patrick Mayr MD,&nbsp;Erion Xhepa MD, PhD,&nbsp;Karl-Ludwig Laugwitz MD,&nbsp;Michael Joner MD,&nbsp;Volker Rudolph MD,&nbsp;Teresa Trenkwalder MD,&nbsp;Tobias Rheude MD,&nbsp;Mark Lachmann MD","doi":"10.1016/j.shj.2026.101051","DOIUrl":"10.1016/j.shj.2026.101051","url":null,"abstract":"<div><h3>Background</h3><div>Persistent tricuspid regurgitation (TR) after mitral transcatheter edge-to-edge repair (M-TEER) is common and associated with adverse outcomes. However, the prognostic relevance of persistent TR may differ depending on anatomical suitability for staged transcatheter tricuspid valve intervention (TTVI). This study aimed to characterize the prevalence, determinants, and prognostic significance of persistent severe TR after M-TEER, with a particular focus on TTVI eligibility.</div></div><div><h3>Methods</h3><div>In this dual-center retrospective cohort study, 905 patients undergoing M-TEER for severe mitral regurgitation between 2015 and 2025 were analyzed. TR severity was assessed at baseline and at 3-month follow-up. Patients with persistent severe TR were categorized as TTVI eligible or TTVI ineligible according to current guideline-based criteria. Multivariable logistic regression identified factors associated with persistent TR, and survival analyses evaluated the prognostic impact of TR persistence.</div></div><div><h3>Results</h3><div>Among 905 patients (median age 79.7 years; 43.4% female), 1-year and 2-year survival rates after M-TEER were 87.7% (95% CI: 85.6%–89.9%) and 77.6% (95% CI: 74.9%–80.4%), respectively. Follow-up echocardiography was available in 454 patients (50.2%). Persistent severe TR was present in 16.3% at 3 months. TTVI-ineligible patients had markedly reduced 2-year survival (39.5%; 95% CI: 22.8%–68.4%), whereas TTVI-eligible patients showed survival similar to those without persistent TR (82.9% [95% CI: 72.8%–94.5%] vs. 87.7% [95% CI: 84.4%–91.2%]). In multivariable analysis, TTVI ineligibility was independently associated with elevated 2-year mortality (hazard ratio [HR]: 5.25 [95% CI: 1.39–19.8]). Advanced right heart remodeling and higher baseline TR severity were strongly associated with TR persistence. Moreover, female sex was independently associated with persistent TR despite similar mitral regurgitation etiology and baseline TR severity between sexes.</div></div><div><h3>Conclusion</h3><div>Persistent TR after M-TEER identifies a high-risk subgroup, but adverse outcomes are primarily driven by patients ineligible for TTVI. Early anticipation of TR persistence, particularly in women, and structured assessment of TTVI eligibility may enable timely intervention and prevent progression to untreatable right-sided heart failure.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 7","pages":"Article 101051"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Utility of the Dicrotic Notch Index in Patients Undergoing Transcatheter Aortic Valve Replacement","authors":"Odette Iskandar MD,&nbsp;Shivabalan Kathavaryan Ramu MD,&nbsp;Maryam Majeed-Saidan MD,&nbsp;Nikolos Spilias MD,&nbsp;Habib Layoun MD,&nbsp;James Yun MD,&nbsp;Grant Reed MD,&nbsp;Rishi Puri MD,&nbsp;Amar Krishnaswamy MD,&nbsp;Samir R. Kapadia MD","doi":"10.1016/j.shj.2026.100849","DOIUrl":"10.1016/j.shj.2026.100849","url":null,"abstract":"<div><h3>Background</h3><div>The dicrotic notch (DN) on the central aortic pressure waveform reflects aortic valve closure. We aimed to assess the clinical utility of the DN index (DNI) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Methods</h3><div>In this retrospective study, we analyzed 569 patients with aortic stenosis who underwent TAVR between January 2019 and December 2020. Aortic waveform data were used to measure systolic, diastolic, and DN pressures, whereas DNI was calculated as (systolic pressure − DN)/pulse pressure. Pre-TAVR and post-TAVR hemodynamic parameters were compared, and survival analysis was performed using Cox regression with post-TAVR/pre-TAVR DNI ratio as an independent covariate.</div></div><div><h3>Results</h3><div>Compared to pre-TAVR, DN pressure (92.18 to 95.37, <em>p</em> &lt; 0.001) and DNI (0.45 to 0.58, <em>p</em> &lt; 0.001) significantly increased post TAVR. Higher baseline DNI was predicted by carotid disease, diabetes mellitus, and a higher ejection fraction at baseline. Post-TAVR to pre-TAVR DNI ratio cut point &gt;1.19 is an independent predictor of event-free survival at 2 years. Patients with higher post-DNI/pre-DNI ratio had a significantly lower risk of all-cause mortality in adjusted analyses (hazard ratio: 0.53, 95% confidence interval [CI]: 0.34–0.82).</div></div><div><h3>Conclusions</h3><div>More than 20% increase in DNI post-TAVR was associated with a lower long-term risk of all-cause mortality. Further studies are needed to understand the determinants of the increase in DNI and if this can be modulated by procedural modifications.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 7","pages":"Article 100849"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aims & Scope","authors":"","doi":"10.1016/S2474-8706(26)00299-X","DOIUrl":"10.1016/S2474-8706(26)00299-X","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 7","pages":"Article 101090"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148499602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discharge After Transcatheter Aortic Valve Implantation: Observational Study of Self-Reported Experiences and Health Status in the Very Early Recovery Period","authors":"Sandra B. Lauck PhD,&nbsp;Maggie Yu MSc,&nbsp;Jopie Polderman BSN,&nbsp;Britt Borregaard PhD,&nbsp;Erin Tang MSN,&nbsp;Chery Low MN-NP,&nbsp;Amanda Smith DNP,&nbsp;Emily K. Phillips MSN,&nbsp;Connie Clark MSN,&nbsp;David A. Wood MD,&nbsp;John Webb MD,&nbsp;Janarthanan Sathananthan MD","doi":"10.1016/j.shj.2026.100794","DOIUrl":"10.1016/j.shj.2026.100794","url":null,"abstract":"<div><h3>Background</h3><div>Early discharge home is the standard of care after transcatheter aortic valve implantation (TAVI). Transition home can be challenging for this population. We lack evidence of patients’ experiences during their immediate recovery to develop targeted and effective interventions. We aimed to describe patients’ self-reported readiness; supports for early discharge; and very early experience of physical health status, activities of daily living, and procedure-related events after TAVI.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational study at five Canadian hospitals; registered nurses and nurse practitioners conducted telephone assessments three and 10 days after TAVI to document patients’ self-reports.</div></div><div><h3>Results</h3><div>We recruited 188 patients (81.6 years, SD ​= ​7.0, 41.5% female) treated with local anesthesia or conscious sedation (n ​= ​171, 91.0%) and balloon-expandable device (77.7%). All patients reported feeling “totally ready” (88.1%) or “somewhat ready” (11.9%) for discharge, and 95.5% returned home with social support. On day 3, most participants completed all activities of daily living (n ​= ​165, 93.2%) and at least six instrumental activities of daily living (n ​= ​105, 59.3%). Their self-reported level of energy was moderate (n ​= ​89, 51.7%), high, or very high (n ​= ​34, 19.8%) and increased by 88.4% by day 10 (n ​= ​49). On day 3, most patients (n ​= ​139, 80.3%) restricted their mobilization to their home, with a 77% increase in daily walking by day 10.</div></div><div><h3>Conclusions</h3><div>Most patients report high level of self-efficacy, self-care behavior, and improved physical status in the first week after TAVI. Research is needed to identify, monitor, and intervene in patients who do not follow this trajectory.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 6","pages":"Article 100794"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response Letter: Interpreting Echocardiographic Right Ventricular–Pulmonary Arterial Coupling Indices After Transcatheter Tricuspid Intervention","authors":"Jennifer von Stein MD,&nbsp;Christos Iliadis MD","doi":"10.1016/j.shj.2026.100845","DOIUrl":"10.1016/j.shj.2026.100845","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 6","pages":"Article 100845"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"82485 | Utilization Trends and In-Hospital Outcomes of Transcatheter Edge-to-Edge Repair Versus Surgical Mitral Valve Intervention","authors":"Brett Cohen,&nbsp;Bryce Allen,&nbsp;Saran Singh,&nbsp;Aarjuv Majmundar,&nbsp;Nicholas Roma,&nbsp;Luke Miller,&nbsp;Michael Durkin","doi":"10.1016/j.shj.2026.100889","DOIUrl":"10.1016/j.shj.2026.100889","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 6","pages":"Article 100889"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"82824 | Hemodynamic Changes After Transcatheter Valve Repair and Replacement for Tricuspid Regurgitation","authors":"Mohamad Saleh Alabdaljabar,&nbsp;Mohamed Elhadi,&nbsp;Jeremy Thaden,&nbsp;Sorin Pislaru,&nbsp;Benjamin Hibbert,&nbsp;Trevor Simard,&nbsp;Mohamad Alkhouli,&nbsp;Mayra Guerrero,&nbsp;Chet Rihal,&nbsp;Mackram Eleid","doi":"10.1016/j.shj.2026.100919","DOIUrl":"10.1016/j.shj.2026.100919","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 6","pages":"Article 100919"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"83013 | Pulmonary Artery Pulsatility Index and Clinical Outcomes in Patients Undergoing Transcatheter Tricuspid Valve Replacement","authors":"Alexandru Patrascu,&nbsp;Kitae Kim,&nbsp;Robert Kay,&nbsp;Prasham Dave,&nbsp;Abdulaziz Al-Shaibi,&nbsp;Gianluigi Bisleri,&nbsp;Michael Ruiz,&nbsp;Tasnim Vira,&nbsp;Kendra Derry,&nbsp;Sami Alnasser,&nbsp;Neil Fam,&nbsp;Alice Moroni","doi":"10.1016/j.shj.2026.100943","DOIUrl":"10.1016/j.shj.2026.100943","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 6","pages":"Article 100943"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"82804 | Hypo-attenuated Leaflet Thickening in Current Balloon-expandable Transcatheter Heart Valves: Incidence and Predictors From a High-volume Single-center Computed Tomography Study","authors":"Gaetano Liccardo,&nbsp;Osung Kwon,&nbsp;Lorenzo Fargione,&nbsp;Nicolas Amabile,&nbsp;Hakim Benamer,&nbsp;Stephane Champagne,&nbsp;Bernard Chevalier,&nbsp;Livio D'Angelo,&nbsp;Jérôme Garot,&nbsp;Philippe Garot,&nbsp;Thomas Hovasse,&nbsp;Pietro Laforgia,&nbsp;Antoinette Neylon,&nbsp;Neila Sayah,&nbsp;Francesca Sanguineti,&nbsp;Thierry Unterseeh,&nbsp;Mariama Akodad","doi":"10.1016/j.shj.2026.100918","DOIUrl":"10.1016/j.shj.2026.100918","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 6","pages":"Article 100918"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"82977 | Impact of Residual Tricuspid Regurgitation after Transcatheter Tricuspid Therapies on Right and Left Ventricular Mechanics","authors":"Giulio Mondellini,&nbsp;Antoon van den Enden,&nbsp;Mark Van den Dorpel,&nbsp;Christiaan Meuwese,&nbsp;Nicolas Van Mieghem","doi":"10.1016/j.shj.2026.100938","DOIUrl":"10.1016/j.shj.2026.100938","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 6","pages":"Article 100938"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}