Dennis Rottländer, Jörg Hausleiter, Thomas Schmitz, Alexander Bufe, Melchior Seyfarth, Ralph Stephan von Bardeleben, Harald Beucher, Taoufik Ouarrak, Steffen Schneider, Peter Boekstegers
{"title":"术中3d静脉收缩面积预测经导管边缘到边缘修复后的生存：来自MITRA-PRO注册表的结果。","authors":"Dennis Rottländer, Jörg Hausleiter, Thomas Schmitz, Alexander Bufe, Melchior Seyfarth, Ralph Stephan von Bardeleben, Harald Beucher, Taoufik Ouarrak, Steffen Schneider, Peter Boekstegers","doi":"10.1007/s00392-024-02580-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The MITRA-PRO registry revealed residual mitral regurgitation (MR) to be an important predictor of survival following transcatheter edge-to-edge repair (TEER). Intraprocedural MR assessment using 3D-Vena Contracta Area (VCA) might be a feasible tool to guide mitral TEER procedures. The study aimed to assess the impact of residual MR assessed by 3D-VCA on 1-year mortality.</p><p><strong>Methods: </strong>823 patients with residual MR quantification using 3D-VCA in the MITRA-PRO registry, were included in this study. 1-year mortality, NYHA classification and major adverse events were assessed 1-year after mitral TEER.</p><p><strong>Results: </strong>Patients with trace residual MR after mitral TEER were allocated to the 3D-VCA < 0.1 cm<sup>2</sup> group (27.8%), while a 3D-VCA ≥ 0.1 < 0.3 cm<sup>2</sup> (55.4%) was considered as mild and a 3D-VCA ≥ 0.3 cm<sup>2</sup> (16.8%) as relevant residual MR. One-year mortality was significantly lower in patients with non-relevant residual MR (3D-VCA < 0.1 cm<sup>2</sup>: 10.5%; ≥ 0.1 < 0.3 cm<sup>2</sup>: 16.0%; ≥ 0.3: 24.8%, p = 0.003). An increasing 3D-VCA post mitral TEER was associated with a higher 1-year mortality. At a 3D-VCA of 0.07 cm<sup>2</sup> mortality increased significantly (1-year mortality 3D-VCA post mitral TEER ≥ 0.07 cm<sup>2</sup>: 16.5% vs. < 0.07 cm<sup>2</sup>: 7.8%; p = 0.005) indicating a 3D-VCA of 0.07 cm<sup>2</sup> to be a cut-off value for survival in daily practice.</p><p><strong>Conclusions: </strong>Residual MR assessed by 3D-VCA after TEER is associated with 1-year mortality. Therefore, 3D-VCA is a valuable echocardiographic tool for intraprocedural MR assessment during mitral TEER and achieving a lower 3D-VCA improve patient survival. (German Clinical Trials Register: DRKS00012288).</p><p><strong>Trial registration number: </strong>DRKS00012288.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intraprocedural 3D-vena contracta area predicts survival after transcatheter edge-to-edge repair: results from MITRA-PRO registry.\",\"authors\":\"Dennis Rottländer, Jörg Hausleiter, Thomas Schmitz, Alexander Bufe, Melchior Seyfarth, Ralph Stephan von Bardeleben, Harald Beucher, Taoufik Ouarrak, Steffen Schneider, Peter Boekstegers\",\"doi\":\"10.1007/s00392-024-02580-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The MITRA-PRO registry revealed residual mitral regurgitation (MR) to be an important predictor of survival following transcatheter edge-to-edge repair (TEER). Intraprocedural MR assessment using 3D-Vena Contracta Area (VCA) might be a feasible tool to guide mitral TEER procedures. The study aimed to assess the impact of residual MR assessed by 3D-VCA on 1-year mortality.</p><p><strong>Methods: </strong>823 patients with residual MR quantification using 3D-VCA in the MITRA-PRO registry, were included in this study. 1-year mortality, NYHA classification and major adverse events were assessed 1-year after mitral TEER.</p><p><strong>Results: </strong>Patients with trace residual MR after mitral TEER were allocated to the 3D-VCA < 0.1 cm<sup>2</sup> group (27.8%), while a 3D-VCA ≥ 0.1 < 0.3 cm<sup>2</sup> (55.4%) was considered as mild and a 3D-VCA ≥ 0.3 cm<sup>2</sup> (16.8%) as relevant residual MR. One-year mortality was significantly lower in patients with non-relevant residual MR (3D-VCA < 0.1 cm<sup>2</sup>: 10.5%; ≥ 0.1 < 0.3 cm<sup>2</sup>: 16.0%; ≥ 0.3: 24.8%, p = 0.003). An increasing 3D-VCA post mitral TEER was associated with a higher 1-year mortality. At a 3D-VCA of 0.07 cm<sup>2</sup> mortality increased significantly (1-year mortality 3D-VCA post mitral TEER ≥ 0.07 cm<sup>2</sup>: 16.5% vs. < 0.07 cm<sup>2</sup>: 7.8%; p = 0.005) indicating a 3D-VCA of 0.07 cm<sup>2</sup> to be a cut-off value for survival in daily practice.</p><p><strong>Conclusions: </strong>Residual MR assessed by 3D-VCA after TEER is associated with 1-year mortality. Therefore, 3D-VCA is a valuable echocardiographic tool for intraprocedural MR assessment during mitral TEER and achieving a lower 3D-VCA improve patient survival. (German Clinical Trials Register: DRKS00012288).</p><p><strong>Trial registration number: </strong>DRKS00012288.</p>\",\"PeriodicalId\":10474,\"journal\":{\"name\":\"Clinical Research in Cardiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-12-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Research in Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00392-024-02580-6\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Research in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00392-024-02580-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Intraprocedural 3D-vena contracta area predicts survival after transcatheter edge-to-edge repair: results from MITRA-PRO registry.
Background: The MITRA-PRO registry revealed residual mitral regurgitation (MR) to be an important predictor of survival following transcatheter edge-to-edge repair (TEER). Intraprocedural MR assessment using 3D-Vena Contracta Area (VCA) might be a feasible tool to guide mitral TEER procedures. The study aimed to assess the impact of residual MR assessed by 3D-VCA on 1-year mortality.
Methods: 823 patients with residual MR quantification using 3D-VCA in the MITRA-PRO registry, were included in this study. 1-year mortality, NYHA classification and major adverse events were assessed 1-year after mitral TEER.
Results: Patients with trace residual MR after mitral TEER were allocated to the 3D-VCA < 0.1 cm2 group (27.8%), while a 3D-VCA ≥ 0.1 < 0.3 cm2 (55.4%) was considered as mild and a 3D-VCA ≥ 0.3 cm2 (16.8%) as relevant residual MR. One-year mortality was significantly lower in patients with non-relevant residual MR (3D-VCA < 0.1 cm2: 10.5%; ≥ 0.1 < 0.3 cm2: 16.0%; ≥ 0.3: 24.8%, p = 0.003). An increasing 3D-VCA post mitral TEER was associated with a higher 1-year mortality. At a 3D-VCA of 0.07 cm2 mortality increased significantly (1-year mortality 3D-VCA post mitral TEER ≥ 0.07 cm2: 16.5% vs. < 0.07 cm2: 7.8%; p = 0.005) indicating a 3D-VCA of 0.07 cm2 to be a cut-off value for survival in daily practice.
Conclusions: Residual MR assessed by 3D-VCA after TEER is associated with 1-year mortality. Therefore, 3D-VCA is a valuable echocardiographic tool for intraprocedural MR assessment during mitral TEER and achieving a lower 3D-VCA improve patient survival. (German Clinical Trials Register: DRKS00012288).
期刊介绍：
Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery.
As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
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