{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:52:36Z","timestamp":1791586356703,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Most patients undergoing the mitral transcatheter edge\u2010to\u2010edge repair (TEER) technique are elderly comorbid patients. Low body mass index (BMI)\u2009&lt;\u200923\u2009kg\/m<jats:sup>2<\/jats:sup> has been identified in other elderly populations as a risk factor, but has not been studied sufficiently in mitral TEER.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to study the impact of low BMI (23\u2009kg\/m2) on the outcome after mitral TEER.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing first\u2010time TEER for mitral regurgitation at a single tertiary center were included, with the exclusion of patients with preprocedural hemodynamic instability or missing BMI. The primary endpoint was all\u2010cause mortality. Secondary endpoints were long\u2010term major bleeding or admission with heart failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 120 patients (mean age 76\u2009\u00b1\u200910 years, 76% men) were included in the study. Thirty\u2010nine (31%) had low BMI. Patients with low BMI had a similar symptomatic benefit as patients with BMI\u2009\u2265\u200923\u2009kg\/m<jats:sup>2<\/jats:sup> at 1 year regarding decrease in diuretics dose and decrease in New York Heart Association\u00a0(NYHA)\u00a0class (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). In a multivariable Cox regression analysis, BMI as a continuous variable (hazard ratio [HR]: 0.93 [95% confidence interval, CI: 0.87\u20130.99],\u00a0<jats:italic>p<\/jats:italic>\u2009=\u20090.03) and low BMI (HR: 1.99 [95% CI: 1.12\u20133.52], <jats:italic>p<\/jats:italic>\u2009=\u20090.02) were associated with the primary outcome. Low BMI was not significantly associated with major bleeding (subdistribution hazard ratio [SHR]:\u00a02.39 [95% CI: 0.96\u20135.97], <jats:italic>p<\/jats:italic>\u2009=\u20090.06) or admission with heart failure (SHR: 1.06 [95% CI: 0.61\u20131.88], <jats:italic>p<\/jats:italic>\u2009=\u20090.83) during follow\u2010up with univariable competing risk regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low BMI is a risk factor for mortality after mitral valve TEER, confirming the presence of an \u201cobesity paradox\u201d in this population and should receive attention in patient selection.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31114","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T11:43:11Z","timestamp":1717155791000},"page":"401-407","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Low body mass index and risk of mortality after mitral transcatheter edge\u2010to\u2010edge repair procedure: The \u201cobesity paradox\u201d"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0359-8728","authenticated-orcid":false,"given":"Rasmus","family":"Carter\u2010Storch","sequence":"first","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten T.","family":"Veien","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8137-6496","authenticated-orcid":false,"given":"Nils Sofus Borg","family":"Mogensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Banke","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil Ulrikkaholm","family":"Tofte\u2010Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulham","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Laursen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi Sanchez","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009355"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805374"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806640"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.06.015"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv627"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.023121"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.12.022"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.3101"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.113.068122"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cob.12506"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.12.051"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.110"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.02.009"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.03.358"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.06.006"},{"key":"e_1_2_9_22_1","unstructured":"Nutrition Landscape Information System (NLiS) [Webpage]. 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