Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure
Blanca Trejo‐Velasco, Rodrigo Estévez‐Loureiro, Fernando Carrasco‐Chinchilla, Felipe Fernández‐Vázquez, Dabit Arzamendi, Manuel Pan, Isaac Pascual, Luis Nombela‐Franco, Ignacio J. Amat‐Santos, Xavier Freixa, Rosa Ana Hernández-Antolín, Ramiro Trillo, Leire Andraka Ikazuriaga, José Ramón López-Mínguez, Darío Sanmiguel Cervera, Juan Sanchís, José Luis Díez Gil, Valeriano Ruíz-Quevedo, Cristóbal A. Urbano-Carrillo, Víctor Manuel Becerra‐Muñoz, Tomás Benito‐González, Chi‐Hion Li, Dolores Mesa, Pablo Avanzas, Germán Armijo, Ana Serrador, Laura Sanchís, Covadonga Fernández-Golfín Lobán, Belén Cid-Álvarez, José M. Hernández-García, Carmen Garrote‐Coloma, Estefanıa Fernández‐Peregrina, Miguel Romero, Víctor León, Ignacio Cruz‐González
Abstract
BACKGROUND: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has emerged as a relevant prognostic predictor in HF. In this study, we aimed to assess the prognostic value of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP) ratio as a non-invasive measure of RV-to-PA coupling in patients undergoing TMVR with MitraClip (Abbott, CA, USA). METHODS: Multicentre registry including 228 consecutive patients that underwent successful TMVR with MitraClip. The sample was divided in two groups according to TAPSE/PASP median value: 0.35. The primary combined endpoint encompassed HF readmissions and all-cause mortality. RESULTS: = 0.003. On Cox regression, TAPSE/PASP emerged as a prognostic predictor of the primary combined endpoint, together with STS-Score. TAPSE/PASP was a better prognostic predictor than either TAPSE or PASP separately. CONCLUSIONS: TAPSE/PASP ratio appears as a novel prognostic predictor in patients undergoing MitraClip implantation that might improve risk stratification and candidate selection.