When patients with secondary mitral regurgitation (SMR) undergo transcatheter edge-to-edge repair (TEER), lower levels of residual mitral regurgitation (resMR) are associated with much better two-year outcomes, according to new findings published in JACC: Cardiovascular Interventions.
When patients are in the advanced stages of heart failure and there are signs of left ventricular dilatation (LV-Dil) or right ventricular dysfunction (RV-Dys), however, this additional benefit from lower resMR “is no longer detectable.”
The research team tracked data from more than 800 patients with SMR who underwent TEER. The overall two-year mortality rate was estimated to be 32%, and post-procedural resMR was “significantly associated” with all-cause mortality.
When LV-Dil or RV-Dys are present, the researchers emphasized, patients with SMR can still see significant benefits from undergoing TEER; it’s just this one specific advantage that will not apply to them.
Looking forward, the authors noted that clinicians need a better way to anticipate when SMR patients may present with heart failure with reduced ejection fraction (HFrEF).
“Accordingly, the early referral of HFrEF patients to a dedicated heart failure clinic with a high-volume interventional TEER program is indicated for ensuring optimal medical treatment and timely decision making for interventional therapies,” wrote lead author Satoshi Higuchi, MD, PhD, a cardiologist with the Munich Heart Alliance in Germany, and colleagues. “Furthermore, due to the limitations of transthoracic echocardiography, an earlier implementation of transesophageal echocardiography should be considered for the evaluation of mitral valve anatomy and regurgitation severity because MR severity can be considerably underestimated by transthoracic echocardiography.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.