{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:12:37Z","timestamp":1779127957693,"version":"3.51.4"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Projekt DEAL"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To assess the value of effective regurgitant orifice (ERO) in predicting outcome after edge-to-edge transcatheter mitral valve repair (TMVR) for secondary mitral regurgitation (SMR) and identify the optimal cut-off for patients\u2019 selection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using the EuroSMR (European Registry of Transcatheter Repair for Secondary Mitral Regurgitation) registry, that included patients undergoing edge-to-edge TMVR for SMR between November 2008 and January 2019 in 8 experienced European centres, we assessed the optimal ERO threshold associated with mortality in SMR patients undergoing TMVR, and compared characteristics and outcomes of patients according to baseline ERO.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 1062 patients with severe SMR and ERO quantification by proximal isovelocity surface area method in the registry, ERO was\u2009&lt;\u20090.3\u00a0cm<jats:sup>2<\/jats:sup> in 575 patients (54.1%), who were more symptomatic at baseline (NYHA class\u2009\u2265\u2009III: 91.4% vs. 86.9%, for ERO\u2009&lt;\u2009vs.\u2009\u2265\u20090.3\u00a0cm<jats:sup>2<\/jats:sup>; <jats:italic>P<\/jats:italic>\u2009=\u20090.004). There was no difference in all-cause mortality at 2-year follow-up according to baseline ERO (28.3% vs. 30.0% for ERO\u2009&lt;\u2009vs.\u2009\u2265\u20090.3\u00a0cm<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u2009=\u20090.585). Both patient groups demonstrated significant improvement of at least one NYHA class (61.7% and 73.8%, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), resulting in a prevalence of NYHA class\u2009\u2264\u2009II at 1-year follow-up of 60.0% and 67.4% for ERO\u2009&lt;\u2009vs.\u2009\u2265\u20090.3\u00a0cm<jats:sup>2<\/jats:sup>, respectively (<jats:italic>P<\/jats:italic>\u2009=\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>All-cause mortality at 2\u00a0years after TMVR does not differ if baseline ERO is\u2009&lt;\u2009or\u2009\u2265\u20090.3\u00a0cm<jats:sup>2<\/jats:sup>, and both groups exhibit relevant clinical improvements. Accordingly, TMVR should not be withheld from patients with ERO\u2009&lt;\u20090.3\u00a0cm<jats:sup>2<\/jats:sup> who remain symptomatic despite optimal medical treatment, if TMVR appropriateness was determined by experienced teams in dedicated valve centres.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00392-021-01807-0","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T14:03:22Z","timestamp":1614866602000},"page":"732-739","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Impact of effective regurgitant orifice area on outcome of secondary mitral regurgitation transcatheter repair"],"prefix":"10.1007","volume":"110","author":[{"name":"for the EuroSMR investigators","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Karam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias","family":"Orban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Kalbacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Butter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabien","family":"Praz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith","family":"Lubos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwin","family":"Bannehr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Kassar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aniela","family":"Petrescu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Iliadis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Unterhuber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouk","family":"Asselin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Pfister","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Windecker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Lurz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"von Bardeleben","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Hausleiter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"issue":"2017","key":"1807_CR1","doi-asserted-by":"publisher","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","volume":"38","author":"H Baumgartner","year":"2017","unstructured":"Baumgartner H, Falk V, Bax JJ, de Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Mu\u00f1oz D, Rosenhek R, Sj\u00f6gren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL, ESC Scientific Document Group (2017) ESC\/EACTS Guidelines for the management of valvular heart disease. 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Karam has received consultant fees from Abbott Vascular; M. Orban received speaker fees from Abbott Vascular. S. Windecker has received research and educational grants from Abbott, Amgen, BMS, Bayer, Boston Scientific, Biotronik, CSL, Medtronic, Edwards, Sinomed and Polares; R Pfister received financial support for attending symposia by Abbot Vascular; R S von Banderleben received Speaker fees from Abbott Vascular and Edwards Lifesciences; J. Hausleiter has received research support and speaker honoraria from Abbott Vascular and Edwards Lifesciences. The other investigators have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}