Journal of Clinical Medicine (Mar 2021)
Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure
- Blanca Trejo-Velasco,
- Rodrigo Estevez-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-Nouche,
- Leire Andraka Ikazuriaga,
- José R. López-Mínguez,
- Dario Sanmiguel Cervera,
- Juan Sanchis,
- José Luis Diez-Gil,
- Valeriano Ruiz-Quevedo,
- Cristóbal Urbano-Carrillo,
- Víctor Manuel Becerra-Muñoz,
- Tomás Benito-González,
- Chi Hion Li,
- Dolores Mesa,
- Pablo Avanzas,
- Germán Armijo,
- Ana María Serrador-Frutos,
- Laura Sanchis,
- Covadonga Fernández-Golfín Lobán,
- Belén Cid-Álvarez,
- José María Hernández-García,
- Carmen Garrote-Coloma,
- Estefanía Fernández-Peregrina,
- Miguel Romero,
- Víctor León Arguero,
- Ignacio Cruz-González
Affiliations
- Blanca Trejo-Velasco
- Cardiology Department, University Hospital of Salamanca, Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
- Rodrigo Estevez-Loureiro
- Cardiology Department, Alvaro Cunqueiro University Hospital, 36213 Vigo, Spain
- Fernando Carrasco-Chinchilla
- Cardiology Department, Virgen de la Victoria University Hospital, Biomedical Research Institute of Málaga, 29010 Málaga, Spain
- Felipe Fernández-Vázquez
- Cardiology Department, University Hospital of Leon, 24071 Leon, Spain
- Dabit Arzamendi
- Cardiology Department, University Hospital Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Manuel Pan
- Cardiology Department, University Hospital Reina Sofia, University of Cordoba and Maimonides Institute for Biomedical Research (IMIBIC), 14004 Córdoba, Spain
- Isaac Pascual
- Heart Area, Asturias Central University Hospital, University of Oviedo, Health Research Institute, 33011 Oviedo, Spain
- Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, Health Research Institute San Carlos (IdISSC), 28040 Madrid, Spain
- Ignacio J. Amat-Santos
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
- Xavier Freixa
- Cardiology Department, Clínic University Hospital of Barcelona, University of Barcelona, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), 08041 Barcelona, Spain
- Rosa Ana Hernández-Antolín
- Cardiology Department, Ramon y Cajal University Hospital, 28034 Madrid, Spain
- Ramiro Trillo-Nouche
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
- Leire Andraka Ikazuriaga
- Cardiology Department, University Hospital of Basurto, 48013 Bilbao, Spain
- José R. López-Mínguez
- Cardiology Department, University Hospital of Badajoz, 06080 Badajoz, Spain
- Dario Sanmiguel Cervera
- Cardiology Department, General University Hospital of Valencia, 46014 Valencia, Spain
- Juan Sanchis
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
- José Luis Diez-Gil
- Cardiology Department, University & Polytechnical Hospital La Fe, 46026 Valencia, Spain
- Valeriano Ruiz-Quevedo
- Cardiology Department, University Hospital of Navarra, 31008 Pamplona, Spain
- Cristóbal Urbano-Carrillo
- Cardiology Department, Regional University Hospital of Málaga, 29010 Málaga, Spain
- Víctor Manuel Becerra-Muñoz
- Cardiology Department, Virgen de la Victoria University Hospital, Biomedical Research Institute of Málaga, 29010 Málaga, Spain
- Tomás Benito-González
- Cardiology Department, University Hospital of Leon, 24071 Leon, Spain
- Chi Hion Li
- Cardiology Department, University Hospital Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Dolores Mesa
- Cardiology Department, University Hospital Reina Sofia, University of Cordoba and Maimonides Institute for Biomedical Research (IMIBIC), 14004 Córdoba, Spain
- Pablo Avanzas
- Heart Area, Asturias Central University Hospital, University of Oviedo, Health Research Institute, 33011 Oviedo, Spain
- Germán Armijo
- Cardiovascular Institute, Hospital Clínico San Carlos, Health Research Institute San Carlos (IdISSC), 28040 Madrid, Spain
- Ana María Serrador-Frutos
- Cardiology Department, Clinic University Hospital of Valladolid, Heart Sciences Institute, 47003 Valladolid, Spain
- Laura Sanchis
- Cardiology Department, Clínic University Hospital of Barcelona, University of Barcelona, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), 08041 Barcelona, Spain
- Covadonga Fernández-Golfín Lobán
- Cardiology Department, Ramon y Cajal University Hospital, 28034 Madrid, Spain
- Belén Cid-Álvarez
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
- José María Hernández-García
- Cardiology Department, Virgen de la Victoria University Hospital, Biomedical Research Institute of Málaga, 29010 Málaga, Spain
- Carmen Garrote-Coloma
- Cardiology Department, University Hospital of Leon, 24071 Leon, Spain
- Estefanía Fernández-Peregrina
- Cardiology Department, University Hospital Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Miguel Romero
- Cardiology Department, University Hospital Reina Sofia, University of Cordoba and Maimonides Institute for Biomedical Research (IMIBIC), 14004 Córdoba, Spain
- Víctor León Arguero
- Heart Area, Asturias Central University Hospital, University of Oviedo, Health Research Institute, 33011 Oviedo, Spain
- Ignacio Cruz-González
- Cardiology Department, University Hospital of Salamanca, Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
- DOI
- https://doi.org/10.3390/jcm10051006
- Journal volume & issue
-
Vol. 10,
no. 5
p. 1006
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: Mean age was 72.5 ± 11.5 years and 154 (67.5%) patients were male. HF readmissions and all-cause mortality were more frequent in patients with TAPSE/PASP ≤ 0.35: Log-Rank 8.844, p = 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.
Keywords
- MitraClip
- mitral valve repair
- mitral valve regurgitation
- pulmonary hypertension
- right ventricular to pulmonary arterial coupling
- transthoracic echocardiography