{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:10:54Z","timestamp":1791447054205,"version":"4.3.3"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to examine frailty measures for risk prediction in patients undergoing percutaneous mitral valve repair (PMVR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Performance of current risk prediction models based on organ morbidity is only moderate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The frailty domains exhaustion, slowness, inactivity, weakness, and unintentional weight loss were prospectively assessed in patients undergoing PMVR. The association with mortality and heart failure hospitalization (HFH) during a median follow\u2010up of 506\u2009days was examined and relevant domains were assessed for additive predictive performance over the MitraScore.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five hundred twenty\u2010four patients were included in the study (mean age [SD]: 77 (9) years, 54.6% male). The risk of mortality and mortality\/HFH were significantly increased in patients with exhaustion (hazard ratio: 2.24 [95% CI: 1.63\u20133.08]\/1.83 [1.21\u20132.77]), slowness (2.74 [1.75\u20134.30]\/1.92 [1.34\u20132.75]), inactivity (1.96 [1.26\u20133.05]\/1.61 [1.12\u20132.31]) and weakness (1.83 [1.12\u20132.96]\/1.34 [0.92\u20131.95]), but not in patients with weight loss (1.24 [0.80\u20131.92]\/1.12 [0.78\u20131.61]). A simplified frailty (S\u2010frailty) measure derived from the domains exhaustion and slowness was associated with mortality (4.45 [2.42\u20138.19]) and mortality\/HFH (2.60 [1.64\u20134.13]) independently of clinical risk factors and the MitraScore, respectively. Prediction of mortality by the MitraScore was significantly improved when adding S\u2010frailty (Harrell's C 0.645 vs. 0.700,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Classification of 1\u2010year mortality risk by the MitraScore improved when adding S\u2010frailty (net reclassification index 0.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012 and integrated discrimination index 0.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A simplified frailty measure comprising self\u2010reported exhaustion and gait speed significantly improved risk prediction in patients undergoing PMVR. Assessment of frailty measures should be part of the decision\u2010making process and multiparametric risk scores in patients with severe mitral regurgitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70138","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T04:57:15Z","timestamp":1764651435000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Simplified Frailty Measure Improves Risk Stratification in Patients Undergoing Percutaneous Mitral Valve Repair"],"prefix":"10.1002","volume":"16","author":[{"given":"Clemens","family":"Metze","sequence":"first","affiliation":[{"name":"Department of Cardiology, Heart Center Cologne University of Cologne, Faculty of Medicine and University Hospital  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elric","family":"Zweck","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Iliadis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Cologne University of Cologne, Faculty of Medicine and University Hospital  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria\u00a0Isabel","family":"K\u00f6rber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Cologne University of Cologne, Faculty of Medicine and University Hospital  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Cologne University of Cologne, Faculty of Medicine and University Hospital  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Westenfeld","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Polzin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Halbach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Cologne University of Cologne, Faculty of Medicine and University Hospital  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Baldus","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Cologne University of Cologne, Faculty of Medicine and University Hospital  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Pfister","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Cologne University of Cologne, Faculty of Medicine and University Hospital  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv322"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2013.07.004"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.01.024"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-021-01804-3"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.08.045"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.11.041"},{"key":"e_1_2_12_8_1","first-page":"727","article-title":"2021 ESC\/EACTS Guidelines for the Management of Valvular Heart Disease","volume":"60","author":"Vahanian A.","year":"2021","journal-title":"European Heart Journal"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60613-8"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.841437"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.06.011"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.518"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.007624"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.07.042"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2023.04.011"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1788"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv333"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2024.131768"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.09.051"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12827"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.121.011375"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.08.015"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad595"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.11.012"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12776"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.024"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn420"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12803"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.117.005088"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.10.003"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-023-02360-8"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02008.x"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/60.1.74"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.027"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.05.038"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1611"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaa167"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz187"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.12.054"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.094"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70138","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcsm.70138","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70138","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:42:16Z","timestamp":1772959336000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.70138"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":42,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/jcsm.70138"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.70138","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2024-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70138"}}