Prognostic impact of right ventricular dysfunction following
transcatheter mitral valve repair
Background Little is known regarding the impact of right ventricular
(RV) function on clinical outcomes following MitraClip therapy.
Objectives The aim of this study was to investigate the prognostic
impact of RV dysfunction and its cut-off value following MitraClip
therapy. Methods Consecutive 77 patients (median 79 years, 33% female)
who underwent MitraClip therapy were enrolled. Clinical endpoint was
defined as cardiovascular (CV) events, including cardiovascular death
and rehospitalization for heart failure (HF). Results and conclusions
Twenty-two (29%) patients had primary mitral regurgitation (MR). During
follow-up, 5 patients died due to CV events, 8 were hospitalized for HF.
On univariate Cox regression analysis, CV events were associated with
eGFR (HR; 0.960, 95% CI; 0.926–0.995, p = 0.027), tricuspid annular
plane systolic excursion (TAPSE, HR; 0.874, 95% CI; 0.789–0.968, p =
0.010), and significant residual MR (HR; 11.652, 95% CI; 3.257–41.691,
p <0.001). On multivariate Cox regression analysis, TAPSE (HR;
0.788, 95% CI; 0.788–0.987, p = 0.029) and significant residual MR
(HR; 9.373, 95% CI; 2.581–34.033, p = 0.001) were independently
associated with CV events. TAPSE <11 mm was the best cut-off
criteria for predicting CV events. RV function was independently
associated with clinical outcomes following MitraClip therapy. TAPSE is
a simple parameter for predicting CV events in patients with MR who are
undergoing MitraClip therapy.