{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:16:59Z","timestamp":1783117019524,"version":"3.54.6"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"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":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Guideline\u2010directed medical therapy (GDMT), based on the combination of beta\u2010blockers (BB), renin\u2013angiotensin system inhibitors (RASI), and mineralocorticoid receptor antagonists (MRA), is known to have a major impact on the outcome of patients with heart failure with reduced ejection fraction (HFrEF). Although GDMT is recommended prior to mitral valve transcatheter edge\u2010to\u2010edge repair (M\u2010TEER), not all patients tolerate it. We studied the association of GDMT prescription with survival in HFrEF patients undergoing M\u2010TEER for secondary mitral regurgitation (SMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>EuroSMR, a European multicentre registry, included SMR patients with left ventricular ejection fraction &lt;50%. The outcome was 2\u2010year all\u2010cause mortality. Of 1344 patients, BB, RASI, and MRA were prescribed in 1169 (87%), 1012 (75%), and 765 (57%) patients at the time of M\u2010TEER, respectively. Triple GDMT prescription was associated with a lower 2\u2010year all\u2010cause mortality compared to non\u2010triple GDMT (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.60\u20130.91). The association persisted in patients with glomerular filtration rate &lt;30\u2009ml\/min, ischaemic aetiology, or right ventricular dysfunction. Further, a positive impact of triple GDMT prescription on survival was observed in patients with residual mitral regurgitation of \u22652+ (HR 0.62; 95% CI 0.44\u20130.86), but not in patients with residual mitral regurgitation of \u22641+ (HR 0.83; 95% CI 0.64\u20131.08).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Triple GDMT prescription is associated with higher 2\u2010year survival after M\u2010TEER in HFrEF patients with SMR. This association was consistent also in patients with major comorbidities or non\u2010optimal results after M\u2010TEER.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2613","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T03:24:09Z","timestamp":1657077849000},"page":"2152-2161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Guideline\u2010directed medical therapy in patients undergoing transcatheter edge\u2010to\u2010edge repair for secondary mitral regurgitation"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7914-8256","authenticated-orcid":false,"given":"Satoshi","family":"Higuchi","sequence":"first","affiliation":[{"name":"Medizinische Klinik und Poliklinik I Klinikum der Universit\u00e4t M\u00fcnchen  Munich 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(DZHK) Partner Site Hamburg\/L\u00fcbeck\/Kiel  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Koell","sequence":"additional","affiliation":[{"name":"Universit\u00e4res Herz\u2010 und Gef\u00e4\u00dfzentrum Hamburg, Klinik f\u00fcr Kardiologie  Hamburg 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 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Braun","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I Klinikum der Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"Munich Heart Alliance, Partner Site German Center for Cardiovascular Disease (DZHK)  Munich 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