To evaluate the changes in left ventricular diameters and hemodynamics across different mitral regurgitation mechanisms following mitral transcatheter edge-to-edge repair (M-TEER).
Approach:
Study Design: The study evaluated 442 patients assessed for M-TEER between 2014 and 2024, with 411 receiving at least one clip. Pre- and post-procedural echocardiograms were reviewed.
Data Collection: Clinical data were abstracted from medical records, and mitral regurgitation mechanisms were classified using intraprocedural imaging findings.
Outcome Measures: Outcomes included changes in left ventricular end-diastolic diameter, end-systolic diameter, and pulmonary artery systolic pressure.
Key Findings:
Average change in mitral regurgitation grade was −2.42 at 1 month, with a median change of −3 grades.
No statistically significant differences in LV diameter changes across mitral regurgitation subtypes.
Median changes in LV end-diastolic diameter were −0.20 cm (atrial), −0.10 cm (ventricular), and −0.10 cm (degenerative).
Median changes in LV end-systolic diameter were 0.20 cm (atrial), −0.10 cm (ventricular), and 0.05 cm (degenerative).
Pulmonary artery systolic pressure changes varied by subtype: 4 mmHg (atrial), −5.5 mmHg (ventricular), and −3 mmHg (degenerative).
Interpretation:
1-month LV dimensional remodeling following M-TEER was modest and similar across mitral regurgitation mechanisms, while pulmonary artery systolic pressure responses varied by subtype.
Limitations:
No disclosure information was provided.
The study did not include long-term follow-up data.
Conclusion:
The findings suggest that while LV dimensional changes post-M-TEER are modest and similar across mechanisms, pulmonary artery systolic pressure responses differ.
Three of 23 patients experienced heart failure deterioration following medication withdrawal, while adverse drug events occurred only among patients who continued therapy.
