{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T23:40:46Z","timestamp":1792885246991,"version":"4.5.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":610,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Medical Center Mainz of the Johannes Gutenberg University Mainz"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Achieving optimized guideline-directed medical therapy (GDMT) is recommended prior to transcatheter mitral valve edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR). We aimed to propose and validate an easy-to-use score for assessing the quality of GDMT in patients with heart failure with reduced ejection fraction (HFrEF) undergoing M-TEER.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Among the 1641 EuroSMR patients enrolled in the EuroSMR Registry who underwent M-TEER, a total of 1072 patients [median age 74, interquartile range (IQR) 67\u201379 years, 29% female] had complete data on GDMT and a left ventricular ejection fraction \u2264 40% and were included in the current study. We proposed a GDMT score that considers the dosage levels of three medication classes (angiotensin-converting enzyme inhibitors\/angiotensin receptor blockers\/angiotensin receptor-neprilysin inhibitors, beta-blockers, and mineralocorticoid receptor antagonists), with a maximum score of 12 points indicating optimal GDMT. The primary outcome was all-cause mortality. The median GDMT score was 4 points (IQR 3\u20136). All three domains of the scoring system were associated with all-cause mortality (P &amp;lt; 0.05 for all). The overall GDMT score was associated with all-cause mortality (hazard ratio 0.90, 95% confidence interval 0.86\u20130.95 for each 1-point increase in the GDMT score). This association remained significant after adjusting for renal function and co-morbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates the utility of a simple GDMT scoring system for assessing the adequacy of GDMT in HFrEF patients with relevant SMR undergoing M-TEER. The GDMT score has potential applications in guiding the design of future clinical trials and aiding clinical decision-making processes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14705","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T02:04:44Z","timestamp":1707876284000},"page":"1802-1807","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Guideline-Directed Medical Therapy Assessment in Heart Failure Patients Undergoing Percutaneous Mitral Valve Repair"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8616-6751","authenticated-orcid":false,"given":"Karl-Patrik","family":"Kresoja","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Center of Mainz , Mainz ,","place":["Germany"]},{"name":"Department of Internal Medicine\/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Science , Str\u00fcmpellstra\u00dfe 39, Leipzig, 04289 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Phillipp","family":"Rommel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of Mainz , Mainz ,","place":["Germany"]},{"name":"Department of Internal Medicine\/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Science , Str\u00fcmpellstra\u00dfe 39, Leipzig, 04289 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Stolz","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Cardiology, European Hospital Georges Pompidou and Paris Cardiovascular Research Center, INSERM U970 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Giannini","sequence":"additional","affiliation":[{"name":"Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Melica","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia , Espinho ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph Stephan","family":"von Bardeleben","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of Mainz , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Butter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Immanuel Heart Center Bernau, Brandenburg Medical School Theodor Fontane , Bernau ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Horn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, University Hospital of D\u00fcsseldorf , D\u00fcsseldorf ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Praz","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Kardiologie, Inselspital Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kalbacher","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Iliadis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, University Hospital of Cologne , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of Mainz , Mainz ,","place":["Germany"]},{"name":"Department of Internal Medicine\/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Science , Str\u00fcmpellstra\u00dfe 39, Leipzig, 04289 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Hausleiter","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Lurz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of Mainz , Mainz ,","place":["Germany"]},{"name":"Department of Internal Medicine\/Cardiology, Heart Center Leipzig 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