Comparative Impact of Transcatheter Edge-to-Edge Mitral Valve Repair on Forward Stroke Volume

Overview

This study evaluates the early effects of transcatheter edge-to-edge mitral valve repair (M-TEER) on forward stroke volume (FSV) in patients with atrial versus ventricular secondary mitral regurgitation (MR). It highlights the potential of FSV as a predictive marker for outcomes related to all-cause mortality and heart failure hospitalization.

Background

Transcatheter edge-to-edge mitral valve repair (M-TEER) is increasingly recommended for patients with severe secondary MR, particularly those at high surgical risk. Understanding the differential impacts of M-TEER on FSV in atrial versus ventricular MR is crucial, as it may guide patient selection and improve clinical outcomes. Current guidelines emphasize the importance of accurate risk stratification and the need for effective interventions in this patient population.

Data Highlights

No numerical data available in the provided material.

Key Findings

• M-TEER is recommended for patients with severe secondary MR at high surgical risk.
• FSV may serve as a more accurate marker of left ventricular dysfunction compared to left ventricular ejection fraction (LVEF).
• Patients with low baseline FSV showed the greatest benefit from M-TEER, despite no improvement in FSV during follow-up.
• Atrial MR is recognized as a distinct phenotype with limited evidence for M-TEER, but recent studies suggest similar clinical benefits.
• Current guidelines recommend M-TEER for symptomatic patients with atrial MR.

Clinical Implications

Clinicians should consider FSV as a key parameter in assessing patients for M-TEER, particularly in differentiating between atrial and ventricular MR. Understanding the distinct characteristics and outcomes associated with each type of MR can enhance patient selection and optimize therapeutic strategies.

Conclusion

The study underscores the importance of FSV in predicting outcomes following M-TEER in secondary MR. Further research is needed to solidify these findings and refine patient selection criteria.

Related Resources & Content

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5. ESC Guidelines, 2025 -- Essential Messages on VHD
6. Growing Evidence for Edge-to-Edge Repair in Secondary Mitral Regurgitation, JACC
7. Understanding the Effects of Mitral Transcatheter Edge-to-Edge Repair, JACC
8. https://www.escardio.org/static-file/Escardio/Guidelines/Products/Essential%20Messages/2025%20Gls/2025%20Essential%20Messages_VHD.pdf
9. Growing Evidence for Edge-to-Edge Repair in Secondary Mitral Regurgitation: What to Learn From COAPT, MITRA-FR, and RESHAPE-HF2 | JACC: Cardiovascular Interventions
10. Understanding the Effects of Mitral Transcatheter Edge-to-Edge Repair on Left Ventricular Function Using Pressure-Volume Loops | JACC: Advances