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Patients with FMR were enrolled who underwent PMVR using the MitraClip<jats:sup>\u00ae<\/jats:sup> device. Procedural success was defined as reduction of MR of at least one grade to MR grade\u2009\u2264\u20092\u2009+\u2009assessed at discharge. Recurrence of MR was defined as MR grade 3\u2009+\u2009or worse at one year after initially successful PMVR. A total of 306 patients with FMR underwent PMVR procedure. In 279 out of 306 patients (91.2%), PMVR was successfully performed with MR grade\u2009\u2264\u20092\u2009+\u2009at discharge. In 11.4% of these patients, MR recurrence of initial successful PMVR after 1\u00a0year was observed. Recurrence of MR was associated with a higher rate of heart failure rehospitalization during the 12\u00a0months follow-up (52.0% vs. 30.3%; <jats:italic>p<\/jats:italic>\u2009=\u20090.029), and less improvement in New York Heart Association (NYHA) functional class [68% vs. 19% of the patients presenting with NYHA functional class III or IV one year after PMVR when compared to patients without recurrence (<jats:italic>p<\/jats:italic>\u2009=\u20090.001)]. Patients with MR recurrence were characterized by a higher left ventricular sphericity index {0.69 [Interquartile range (IQR) 0.64, 0.74] vs. 0.65 (IQR 0.58, 0.70), <jats:italic>p<\/jats:italic>\u2009=\u20090.003}, a larger left atrium volume [118 (IQR 96, 143) ml vs. 102 (IQR 84, 123) ml, <jats:italic>p<\/jats:italic>\u2009=\u20090.019], a larger tenting height 10 (IQR 9, 13) mm vs. 8 (IQR 7, 11) mm (<jats:italic>p<\/jats:italic>\u2009=\u20090.047), and a larger mitral valve annulus [41 (IQR 38, 43) mm vs. 39 (IQR 36, 40) mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.015] when compared to patients with durable optimal long-term results. In a multivariate regression model, the left ventricular sphericity index [Odds Ratio (OR) 1.120, 95% Confidence Interval (CI) 1.039\u20131.413, <jats:italic>p<\/jats:italic>\u2009=\u20090.003)], tenting height (OR 1.207, 95% CI 1.031\u20131.413, <jats:italic>p<\/jats:italic>\u2009=\u20090.019), and left atrium enlargement (OR 1.018, 95% CI 1.000\u20131.038, <jats:italic>p<\/jats:italic>\u2009=\u20090.047) were predictors for MR recurrence after 1\u00a0year. In patients with FMR, baseline parameters of advanced heart failure such as spherical ventricle, tenting height and a large left atrium might indicate risk of recurrent MR one year after PMVR.<\/jats:p>","DOI":"10.1007\/s00380-021-01828-9","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T04:02:39Z","timestamp":1617422559000},"page":"1574-1583","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Predictors of functional mitral regurgitation recurrence after percutaneous mitral valve repair"],"prefix":"10.1007","volume":"36","author":[{"given":"Katharina","family":"Hellhammer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean M.","family":"Haurand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Spieker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Luedike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Zeus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte","family":"Kelm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Westenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5260-1321","authenticated-orcid":false,"given":"Patrick","family":"Horn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,3]]},"reference":[{"key":"1828_CR1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/eurheartj\/ehx402","volume":"39","author":"G Goliasch","year":"2018","unstructured":"Goliasch G, Bartko PE, Pavo N, Neuhold S, Wurm R, Mascherbauer J, Lang IM, Strunk G, Hulsmann M (2018) Refining the prognostic impact of functional mitral regurgitation in chronic heart failure. 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