Photo Credit: Pitchayanan Kongkaew
The following is a summary of “Hyperacute Effects of Mitral Transcatheter Edge-to-Edge Repair on Left Ventricular Volumes and Functions,” published in the January 2025 issue of Cardiology by Kassar et al.
The acute impact of transcatheter edge-to-edge repair (TEER) on left ventricular (LV) function in high-risk patients with severe symptomatic mitral regurgitation (MR) remains underexplored using advanced echocardiographic techniques.
Researchers conducted a retrospective study to investigate the immediate effects of TEER on LV volumes and functions and the influence on mid-term outcomes using high-resolution 3D transesophageal echocardiography.
They included 80 patients undergoing TEER for severe MR, with a mean age of 79±8 years, and 49% had primary MR. The High-resolution 3D transesophageal echocardiography assessed LV volumes and function before and after the procedure.
The results showed that post-TEER, LV end-diastolic volume (LVEDV) decreased from 161±61 ml to 147±54 ml, and stroke volume dropped from 69±18 ml to 50±15 ml. End-systolic volume increased from 92±60 ml to 97±45 ml (P <0.0001). The LV ejection fraction (LVEF) declined from 48±16% to 38±14%, global longitudinal strain (GLS) reduced from 16.2±6.8% to 12.8±5.4%, and global circumferential strain (GCS) fell from 25±10.5% to 18.7±8.5% (P <0.0001). LVEF and GCS reductions correlated with baseline values and afterload reduction, indicated by a 3D vena contracta area decrease (r=0.47 and r=0.65; P <0.0001), while GLS was linked to baseline values and inversely related to LVEDV (r=0.63; P <0.0001). Relative LVEF reduction was the strongest mortality predictor, with a hazard ratio of 1.76 (1.12–2.76) per 10% decrease.
Investigators concluded the acute decline in LV function after TEER was associated with MR reduction, greater impacts on circumferential function, and higher baseline LVEF, with relative LVEF reduction serving as a key predictor of mortality.
Source: ajconline.org/article/S0002-9149(25)00011-6/abstract
