Philipp von Stein,Lukas Stolz,Jean Marc Haurand,Matthias Gröger,Felix Rudolph,Donika Mustafa,Jannik Jobst,Christoph Alexander Mues,Amir Abbas Mahabadi,Isabel A Hoerbrand,Carl Schulz,Atsushi Sugiura,Jennifer von Stein,Christos Iliadis,Philipp Lurz,Muhammed Gerçek,Patrick Horn,Mirjam Kessler,Guido Ascione,Tienush Rassaf,Marcel Weber,Niklas Schofer,Mathias Konstandin,Florian Schindhelm,Helge Möllmann,Bernhard Unsöld,Henning Guthoff,Stephan Baldus,Wolfgang Rottbauer,Volker Rudolph,Juan F Granada,Jörg Hausleiter,Roman Pfister,Victor Mauri,
{"title":"经导管边缘到边缘修复心房和心室继发性二尖瓣反流：来自修复研究的见解。","authors":"Philipp von Stein,Lukas Stolz,Jean Marc Haurand,Matthias Gröger,Felix Rudolph,Donika Mustafa,Jannik Jobst,Christoph Alexander Mues,Amir Abbas Mahabadi,Isabel A Hoerbrand,Carl Schulz,Atsushi Sugiura,Jennifer von Stein,Christos Iliadis,Philipp Lurz,Muhammed Gerçek,Patrick Horn,Mirjam Kessler,Guido Ascione,Tienush Rassaf,Marcel Weber,Niklas Schofer,Mathias Konstandin,Florian Schindhelm,Helge Möllmann,Bernhard Unsöld,Henning Guthoff,Stephan Baldus,Wolfgang Rottbauer,Volker Rudolph,Juan F Granada,Jörg Hausleiter,Roman Pfister,Victor Mauri,","doi":"10.1016/j.jcin.2025.05.031","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nSecondary mitral regurgitation (SMR) has 2 phenotypes: atrial (aSMR) and ventricular (vSMR). The role of mitral valve transcatheter edge-to-edge repair (M-TEER) in aSMR remains less defined, with limited evidence on the PASCAL implant (Edwards Lifesciences).\r\n\r\nOBJECTIVES\r\nThe authors sought to evaluate and compare outcomes of SMR phenotypes undergoing M-TEER.\r\n\r\nMETHODS\r\nREPAIR (REgistry of PAscal for mItral Regurgitation) is an investigator-initiated, multicenter registry of patients undergoing M-TEER. aSMR was defined by left atrial dilation with preserved left ventricular size and ejection fraction. Outcomes included MR ≤1+ at discharge, technical success, NYHA functional class improvement, and 1-year survival.\r\n\r\nRESULTS\r\nAmong 915 patients (166 [18%] aSMR, 749 [82%] vSMR), the median follow-up was 491 days (Q1-Q3: 360-833 days). MR ≤1+ was achieved in 77.2% vs 71.4% (P = 0.162), with technical success in 97.0% vs 98.3% (P = 0.446). NYHA functional class improved in both phenotypes (P < 0.001), with 61.2% vs 61.3% in functional class ≤II at follow-up (P > 0.999). One-year survival was 88.4% (95% CI: 82.8%-94.4%) vs 86.0% (95% CI: 83.1%-89.0%; P = 0.346). In aSMR patients, 1-year survival was significantly lower in patients with baseline tricuspid regurgitation (TR) grade ≥moderate compared with those with <moderate TR (84.3% [95% CI: 77.0%-92.3%] vs 100.0% [95% CI: 100.0%-100.0%]; P = 0.041). In vSMR patients, survival was similar between ≥moderate and <moderate baseline TR (83.9% [95% CI: 79.8%-88.2%] vs 89.3% [95% CI: 85.0%-93.8%]; P = 0.051).\r\n\r\nCONCLUSIONS\r\nM-TEER effectively reduces MR to ≤1+ and improves symptoms in both aSMR and vSMR. Particularly in aSMR, ≥moderate baseline TR is linked to worse outcomes, warranting consideration as an additional treatment target.","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"1 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Transcatheter Edge-to-Edge Repair for Atrial and Ventricular Secondary Mitral Regurgitation: Insights From the REPAIR Study.\",\"authors\":\"Philipp von Stein,Lukas Stolz,Jean Marc Haurand,Matthias Gröger,Felix Rudolph,Donika Mustafa,Jannik Jobst,Christoph Alexander Mues,Amir Abbas Mahabadi,Isabel A Hoerbrand,Carl Schulz,Atsushi Sugiura,Jennifer von Stein,Christos Iliadis,Philipp Lurz,Muhammed Gerçek,Patrick Horn,Mirjam Kessler,Guido Ascione,Tienush Rassaf,Marcel Weber,Niklas Schofer,Mathias Konstandin,Florian Schindhelm,Helge Möllmann,Bernhard Unsöld,Henning Guthoff,Stephan Baldus,Wolfgang Rottbauer,Volker Rudolph,Juan F Granada,Jörg Hausleiter,Roman Pfister,Victor Mauri,\",\"doi\":\"10.1016/j.jcin.2025.05.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\r\\nSecondary mitral regurgitation (SMR) has 2 phenotypes: atrial (aSMR) and ventricular (vSMR). The role of mitral valve transcatheter edge-to-edge repair (M-TEER) in aSMR remains less defined, with limited evidence on the PASCAL implant (Edwards Lifesciences).\\r\\n\\r\\nOBJECTIVES\\r\\nThe authors sought to evaluate and compare outcomes of SMR phenotypes undergoing M-TEER.\\r\\n\\r\\nMETHODS\\r\\nREPAIR (REgistry of PAscal for mItral Regurgitation) is an investigator-initiated, multicenter registry of patients undergoing M-TEER. aSMR was defined by left atrial dilation with preserved left ventricular size and ejection fraction. Outcomes included MR ≤1+ at discharge, technical success, NYHA functional class improvement, and 1-year survival.\\r\\n\\r\\nRESULTS\\r\\nAmong 915 patients (166 [18%] aSMR, 749 [82%] vSMR), the median follow-up was 491 days (Q1-Q3: 360-833 days). MR ≤1+ was achieved in 77.2% vs 71.4% (P = 0.162), with technical success in 97.0% vs 98.3% (P = 0.446). NYHA functional class improved in both phenotypes (P < 0.001), with 61.2% vs 61.3% in functional class ≤II at follow-up (P > 0.999). One-year survival was 88.4% (95% CI: 82.8%-94.4%) vs 86.0% (95% CI: 83.1%-89.0%; P = 0.346). In aSMR patients, 1-year survival was significantly lower in patients with baseline tricuspid regurgitation (TR) grade ≥moderate compared with those with <moderate TR (84.3% [95% CI: 77.0%-92.3%] vs 100.0% [95% CI: 100.0%-100.0%]; P = 0.041). In vSMR patients, survival was similar between ≥moderate and <moderate baseline TR (83.9% [95% CI: 79.8%-88.2%] vs 89.3% [95% CI: 85.0%-93.8%]; P = 0.051).\\r\\n\\r\\nCONCLUSIONS\\r\\nM-TEER effectively reduces MR to ≤1+ and improves symptoms in both aSMR and vSMR. Particularly in aSMR, ≥moderate baseline TR is linked to worse outcomes, warranting consideration as an additional treatment target.\",\"PeriodicalId\":14666,\"journal\":{\"name\":\"JACC: Cardiovascular Interventions\",\"volume\":\"1 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC: Cardiovascular Interventions\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jcin.2025.05.031\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC: Cardiovascular Interventions","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jcin.2025.05.031","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Transcatheter Edge-to-Edge Repair for Atrial and Ventricular Secondary Mitral Regurgitation: Insights From the REPAIR Study.
BACKGROUND
Secondary mitral regurgitation (SMR) has 2 phenotypes: atrial (aSMR) and ventricular (vSMR). The role of mitral valve transcatheter edge-to-edge repair (M-TEER) in aSMR remains less defined, with limited evidence on the PASCAL implant (Edwards Lifesciences).
OBJECTIVES
The authors sought to evaluate and compare outcomes of SMR phenotypes undergoing M-TEER.
METHODS
REPAIR (REgistry of PAscal for mItral Regurgitation) is an investigator-initiated, multicenter registry of patients undergoing M-TEER. aSMR was defined by left atrial dilation with preserved left ventricular size and ejection fraction. Outcomes included MR ≤1+ at discharge, technical success, NYHA functional class improvement, and 1-year survival.
RESULTS
Among 915 patients (166 [18%] aSMR, 749 [82%] vSMR), the median follow-up was 491 days (Q1-Q3: 360-833 days). MR ≤1+ was achieved in 77.2% vs 71.4% (P = 0.162), with technical success in 97.0% vs 98.3% (P = 0.446). NYHA functional class improved in both phenotypes (P < 0.001), with 61.2% vs 61.3% in functional class ≤II at follow-up (P > 0.999). One-year survival was 88.4% (95% CI: 82.8%-94.4%) vs 86.0% (95% CI: 83.1%-89.0%; P = 0.346). In aSMR patients, 1-year survival was significantly lower in patients with baseline tricuspid regurgitation (TR) grade ≥moderate compared with those with
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