Evolution of Right Ventricular Function and Pulmonary Artery Coupling After Transapical Transcatheter Mitral Valve Replacement - PubMed
4 hours ago
- #mitral regurgitation
- #transcatheter mitral valve replacement
- #right ventricular function
- Transcatheter mitral valve replacement (TMVR) is an emerging therapy for severe mitral regurgitation (MR) patients unsuitable for surgery or edge-to-edge repair.
- The study evaluated the impact of TMVR on right ventricular (RV) function and RV-pulmonary artery (PA) coupling using data from the multicentre TENDER registry.
- 57.4% of patients had impaired RV-PA coupling (TAPSE/sPAP < 0.4) at baseline.
- One year post-TMVR, systolic PA pressure (sPAP) and tricuspid regurgitation (TR) severity improved, while TAPSE slightly declined.
- Patients with preserved baseline RV-PA coupling had numerically lower rates of mortality and heart failure hospitalization, though not statistically significant.
- Reversal of pulmonary hypertension was associated with lower mortality or rehospitalization risk.
- RV dysfunction and impaired RV-PA coupling are common in TMVR candidates and may inform risk stratification.
- Patients with secondary MR, impaired coupling, severe TR, or failed reversal of pulmonary hypertension may need closer follow-up.