Prognostic Impact of Right Ventricular Dysfunction Following Transcatheter Mitral Valve Repair

Abstract

Objective: Little is known regarding the impact of right ventricular (RV) function on clinical outcomes following MitraClip therapy. 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 CV death and rehospitalization for heart failure (HF).

Results: Twenty-two (29%) patients had primary mitral regurgitation (MR). During follow-up, 5 patients died due to CV events and 8 were hospitalized for HF. On univariate Cox regression analysis, CV events were associated with estimated glomerular filtration rate (hazard ratio [HR]: 0.960, 95% confidence interval [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.

Conclusion: 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.