a0ee008f2ec96ea913f4df196f178c74 272101.pdf aa557d60346fc66ecfaa135e4688018d6f7a864b 272101.pdf 1cb88c2112df5bb6340da64636ffb9920918bc603fd5ff2364e678d781d9392e 272101.pdf Title: Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure Subject: Background: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has emerged as a relevant prognostic predictor in HF. In this study, we aimed to assess the prognostic value of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP) ratio as a non-invasive measure of RV-to-PA coupling in patients undergoing TMVR with MitraClip (Abbott, CA, USA). Methods: Multicentre registry including 228 consecutive patients that underwent successful TMVR with MitraClip. The sample was divided in two groups according to TAPSE/PASP median value: 0.35. The primary combined endpoint encompassed HF readmissions and all-cause mortality. Results: Mean age was 72.5 11.5 years and 154 (67.5%) patients were male. HF readmissions and all-cause mortality were more frequent in patients with TAPSE/PASP 0.35: Log-Rank 8.844, p = 0.003. On Cox regression, TAPSE/PASP emerged as a prognostic predictor of the primary combined endpoint, together with STS-Score. TAPSE/PASP was a better prognostic predictor than either TAPSE or PASP separately. Conclusions: TAPSE/PASP ratio appears as a novel prognostic predictor in patients undergoing MitraClip implantation that might improve risk stratification and candidate selection. Keywords: MitraClip; mitral valve repair; mitral valve regurgitation; pulmonary hypertension; right ventricular to pulmonary arterial coupling; transthoracic echocardiography Author: Blanca Trejo-Velasco, Rodrigo Estevez-Loureiro, Fernando Carrasco-Chinchilla, Felipe Fernández-Vázquez, Dabit Arzamendi, Manuel Pan, Isaac Pascual, Luis Nombela-Franco, Ignacio J. Amat-Santos, Xavier Freixa, Rosa Ana Hernández-Antolín, Ramiro Trillo-Nouche, Leire Andraka Ikazuriaga, José R. López-Mínguez, Dario Sanmiguel Cervera, Juan Sanchis, José Luis Diez-Gil, Valeriano Ruiz-Quevedo, Cristóbal Urbano-Carrillo, Víctor Manuel Becerra-Muñoz, Tomás Benito-González, Chi Hion Li, Dolores Mesa, Pablo Avanzas, Germán Armijo, Ana María Serrador-Frutos, Laura Sanchis, Covadonga Fernández-Golfín Lobán, Belén Cid-Álvarez, José María Hernández-García, Carmen Garrote-Coloma, Estefanía Fernández-Peregrina, Miguel Romero, Víctor León Arguero and Ignacio Cruz-González Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Mar 2 10:57:48 2021 CET ModDate: Tue Mar 2 11:10:03 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 822669 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- SDIDBK+VnURWPalladioL Type 1 Custom yes yes no 10 0 YRRAEU+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 UORPXH+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 KSNHZQ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 FFAYKL+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 KOSUXD+CMSY10 Type 1 Builtin yes yes no 81 0 WVWPDJ+PazoMath-Italic Type 1 Builtin yes yes no 91 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 95 0 DWUPHP+EURB7 Type 1 Builtin yes yes no 102 0 QMQJLY+PazoMath Type 1 Builtin yes yes no 109 0 EIIBEM+PalatinoLinotype,Bold CID TrueType Identity-H yes yes yes 123 0 EIIBEN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 129 0 EIIBFO+PalatinoLinotype CID TrueType Identity-H yes yes yes 132 0 EIIBFP+PalatinoLinotype TrueType WinAnsi yes yes no 138 0 EIIBGB+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 141 0 EIIDAJ+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 144 0 ZYYJXI+EURB10 Type 1 Builtin yes yes no 151 0 EIIBEN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 162 0 EIIBFO+PalatinoLinotype CID TrueType Identity-H yes yes yes 165 0 EIIBFP+PalatinoLinotype TrueType WinAnsi yes yes no 171 0 EIIBGB+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 174 0 WABLSD+SFRM1000 Type 1 Custom yes yes no 184 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-27 03:00:04 CEST RepresentationInformation: 272101.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-03-31 12:05:22 CEST Size: 822669 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 356 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Study Design and Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Echocardiography Parameters Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Right Heart Catheterization Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Definitions and Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Children: Item: Title: Baseline Characteristics According to TAPSE/PASP Values Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Survival and Multivariate Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Info: Title: Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure Author: Blanca Trejo-Velasco, Rodrigo Estevez-Loureiro, Fernando Carrasco-Chinchilla, Felipe Fernández-Vázquez, Dabit Arzamendi, Manuel Pan, Isaac Pascual, Luis Nombela-Franco, Ignacio J. Amat-Santos, Xavier Freixa, Rosa Ana Hernández-Antolín, Ramiro Trillo-Nouche, Leire Andraka Ikazuriaga, José R. López-Mínguez, Dario Sanmiguel Cervera, Juan Sanchis, José Luis Diez-Gil, Valeriano Ruiz-Quevedo, Cristóbal Urbano-Carrillo, Víctor Manuel Becerra-Muñoz, Tomás Benito-González, Chi Hion Li, Dolores Mesa, Pablo Avanzas, Germán Armijo, Ana María Serrador-Frutos, Laura Sanchis, Covadonga Fernández-Golfín Lobán, Belén Cid-Álvarez, José María Hernández-García, Carmen Garrote-Coloma, Estefanía Fernández-Peregrina, Miguel Romero, Víctor León Arguero and Ignacio Cruz-González Subject: Background: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has emerged as a relevant prognostic predictor in HF. In this study, we aimed to assess the prognostic value of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP) ratio as a non-invasive measure of RV-to-PA coupling in patients undergoing TMVR with MitraClip (Abbott, CA, USA). Methods: Multicentre registry including 228 consecutive patients that underwent successful TMVR with MitraClip. The sample was divided in two groups according to TAPSE/PASP median value: 0.35. The primary combined endpoint encompassed HF readmissions and all-cause mortality. Results: Mean age was 72.5 11.5 years and 154 (67.5%) patients were male. HF readmissions and all-cause mortality were more frequent in patients with TAPSE/PASP 0.35: Log-Rank 8.844, p = 0.003. On Cox regression, TAPSE/PASP emerged as a prognostic predictor of the primary combined endpoint, together with STS-Score. TAPSE/PASP was a better prognostic predictor than either TAPSE or PASP separately. Conclusions: TAPSE/PASP ratio appears as a novel prognostic predictor in patients undergoing MitraClip implantation that might improve risk stratification and candidate selection. 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