Impact of pulmonary hypertension dynamics and residual mitral
regurgitation shortly after M-TEER on long-term outcomes:
insights from a prospective registry

J 2026

Impact of pulmonary hypertension dynamics and residual mitral regurgitation shortly after M-TEER on long-term outcomes: insights from a prospective registry

HUDEC, Miroslav; Jaroslav JANUSKA; Otakar JIRAVSKY; Roman MIKLIK; Martin URBAN et al.

Základní údaje

Originální název

Impact of pulmonary hypertension dynamics and residual mitral regurgitation shortly after M-TEER on long-term outcomes: insights from a prospective registry

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Vydání

Clinical Research in Cardiology, Heidelberg, Springer, 2026, 1861-0684

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Německo

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.700 v roce 2024

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Transcatheter edge-to-edge repair; MitraClip; Pulmonary hypertension; Mitral regurgitation; Heart failure outcomes; Procedural success

Štítky

14110211

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 10. 3. 2026 10:57, Mgr. Tereza Miškechová

Anotace

V originále

BackgroundPulmonary hypertension (PH) often coexists in patients undergoing transcatheter edge-to-edge mitral valve repair procedure (M-TEER). Its pre-procedural severity is considered a negative prognostic marker. Whether the post-procedural PH resulting from M-TEER can also serve as a long-term prognostic marker is unknown.AimsTo evaluate the influence of residual mitral regurgitation (MR) and the role of PH dynamics on long-term outcome after M-TEER.MethodsA total of 226 patients from a single-centre prospective registry who underwent M-TEER with MitraClips between 2010 and 2022 were analysed. Patients were categorised into four phenotype groups based on a combination of post-procedural MR severity (<= 2.5 vs. >= 3) and change in PH (stable/improved vs. worsened). Primary endpoints were survival, time to first heart failure hospitalisation (HFH) and a composite of both.ResultsOverall, 86.3% of patients had severe MR and 59.7% had PH at baseline, while 75.7% had MR <= 2.5 and 57.5% had no residual PH after M-TEER on discharge echocardiography. Baseline PH severity did not significantly influence outcomes, but its dynamics did (stable/improved vs. worsening; median survival 63 vs. 38 months, time to HFH 74 vs. 44 months, and time to composite endpoint 49 vs. 26 months, all p < 0.05). Patients who achieved mild/moderate MR with stable/improved PH (81.0%) showed the best results across all endpoints (median survival 58 months, p = 0.027; time to HFH 74 months, p = 0.004; time to composite endpoint 50 months, p = 0.008). The groups with worsening PH after M-TEER had the worst outcomes, regardless of the degree of MR.ConclusionAssessment of pH dynamics shortly after M-TEER proved to be a valuable predictor of long-term outcome. Its combination with the post-procedural level of MR can easily identify patients at low or high risk of subsequent adverse outcomes.

Citovat

HUDEC, Miroslav; Jaroslav JANUSKA; Otakar JIRAVSKY; Roman MIKLIK; Martin URBAN; Miloslav DORDA; Alica CESNAKOVA KONECNA; Libor GAJDUSEK; Ivan RANIC; David VICIAN; Radim SPACEK; Bogna JIRAVSKA GODULA; Libor SKNOURIL a Petr KALA. Impact of pulmonary hypertension dynamics and residual mitral regurgitation shortly after M-TEER on long-term outcomes: insights from a prospective registry. Clinical Research in Cardiology. Heidelberg: Springer, 2026, 11 s. ISSN 1861-0684. Dostupné z: https://doi.org/10.1007/s00392-025-02747-9.

@article{2523917,
   author = {Hudec, Miroslav and Januska, Jaroslav and Jiravsky, Otakar and Miklik, Roman and Urban, Martin and Dorda, Miloslav and Cesnakova Konecna, Alica and Gajdusek, Libor and Ranic, Ivan and Vician, David and Spacek, Radim and Jiravska Godula, Bogna and Sknouril, Libor and Kala, Petr},
   article_location = {Heidelberg},
   doi = {https://doi.org/10.1007/s00392-025-02747-9},
   keywords = {Transcatheter edge-to-edge repair; MitraClip; Pulmonary hypertension; Mitral regurgitation; Heart failure outcomes; Procedural success},
   language = {eng},
   issn = {1861-0684},
   journal = {Clinical Research in Cardiology},
   title = {Impact of pulmonary hypertension dynamics and residual mitral regurgitation shortly after M-TEER on long-term outcomes: insights from a prospective registry},
   url = {https://link.springer.com/article/10.1007/s00392-025-02747-9},
   year = {2026}
}

TY  - JOUR
ID  - 2523917
AU  - Hudec, Miroslav - Januska, Jaroslav - Jiravsky, Otakar - Miklik, Roman - Urban, Martin - Dorda, Miloslav - Cesnakova Konecna, Alica - Gajdusek, Libor - Ranic, Ivan - Vician, David - Spacek, Radim - Jiravska Godula, Bogna - Sknouril, Libor - Kala, Petr
PY  - 2026
TI  - Impact of pulmonary hypertension dynamics and residual mitral regurgitation shortly after M-TEER on long-term outcomes: insights from a prospective registry
JF  - Clinical Research in Cardiology
PB  - Springer
SN  - 18610684
KW  - Transcatheter edge-to-edge repair
KW  - MitraClip
KW  - Pulmonary hypertension
KW  - Mitral regurgitation
KW  - Heart failure outcomes
KW  - Procedural success
UR  - https://link.springer.com/article/10.1007/s00392-025-02747-9
N2  - BackgroundPulmonary hypertension (PH) often coexists in patients undergoing transcatheter edge-to-edge mitral valve repair procedure (M-TEER). Its pre-procedural severity is considered a negative prognostic marker. Whether the post-procedural PH resulting from M-TEER can also serve as a long-term prognostic marker is unknown.AimsTo evaluate the influence of residual mitral regurgitation (MR) and the role of PH dynamics on long-term outcome after M-TEER.MethodsA total of 226 patients from a single-centre prospective registry who underwent M-TEER with MitraClips between 2010 and 2022 were analysed. Patients were categorised into four phenotype groups based on a combination of post-procedural MR severity (<= 2.5 vs. >= 3) and change in PH (stable/improved vs. worsened). Primary endpoints were survival, time to first heart failure hospitalisation (HFH) and a composite of both.ResultsOverall, 86.3% of patients had severe MR and 59.7% had PH at baseline, while 75.7% had MR <= 2.5 and 57.5% had no residual PH after M-TEER on discharge echocardiography. Baseline PH severity did not significantly influence outcomes, but its dynamics did (stable/improved vs. worsening; median survival 63 vs. 38 months, time to HFH 74 vs. 44 months, and time to composite endpoint 49 vs. 26 months, all p < 0.05). Patients who achieved mild/moderate MR with stable/improved PH (81.0%) showed the best results across all endpoints (median survival 58 months, p = 0.027; time to HFH 74 months, p = 0.004; time to composite endpoint 50 months, p = 0.008). The groups with worsening PH after M-TEER had the worst outcomes, regardless of the degree of MR.ConclusionAssessment of pH dynamics shortly after M-TEER proved to be a valuable predictor of long-term outcome. Its combination with the post-procedural level of MR can easily identify patients at low or high risk of subsequent adverse outcomes.
ER  -

HUDEC, Miroslav; Jaroslav JANUSKA; Otakar JIRAVSKY; Roman MIKLIK; Martin URBAN; Miloslav DORDA; Alica CESNAKOVA KONECNA; Libor GAJDUSEK; Ivan RANIC; David VICIAN; Radim SPACEK; Bogna JIRAVSKA GODULA; Libor SKNOURIL a Petr KALA. Impact of pulmonary hypertension dynamics and residual mitral regurgitation shortly after M-TEER on long-term outcomes: insights from a prospective registry. \textit{Clinical Research in Cardiology}. Heidelberg: Springer, 2026, 11 s. ISSN~1861-0684. Dostupné z: https://doi.org/10.1007/s00392-025-02747-9.

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