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However, longitudinal data on RV dysfunction and reverse cardiac remodeling in patients following transcatheter edge-to-edge mitral valve repair (M-TEER) are scarce.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Consecutive patients with primary as well as secondary mitral regurgitation (MR) were prospectively enrolled and had comprehensive echocardiographic and invasive hemodynamic assessment at baseline. Kaplan\u2013Meier estimates and multivariable Cox-regression analyses were performed, using a composite endpoint of heart failure hospitalization and death.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Between April 2018 and January 2021, 156 patients (median 78 y\/o, 55% female, EuroSCORE II: 6.9%) underwent M-TEER. On presentation, 64% showed impaired RV\u2013PA coupling defined as tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE\/PASP) ratio\u2009&lt;\u20090.36. Event-free survival rates at 2\u00a0years were significantly lower among patients with impaired coupling (57 vs. 82%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), both in patients with primary (64 vs. 91%, <jats:italic>p<\/jats:italic>\u2009=\u20090.009) and secondary MR (54 vs. 76%, <jats:italic>p<\/jats:italic>\u2009=\u20090.026). On multivariable Cox-regression analyses adjusted for baseline, imaging, hemodynamic, and procedural data, TAPSE\/PASP ratio\u2009&lt;\u20090.36 was independently associated with outcome (adj.HR 2.74, 95% CI 1.17\u20136.43, <jats:italic>p<\/jats:italic>\u2009=\u20090.021).<\/jats:p>\n            <jats:p>At 1-year follow-up, RV\u2013PA coupling improved (TAPSE: \u2206\u2009+\u20093\u00a0mm, PASP: \u2206 \u2212 10\u00a0mmHg, <jats:italic>p<\/jats:italic> for both\u2009&lt;\u20090.001), alongside with a reduction in tricuspid regurgitation (TR) severity (grade\u2009\u2265\u2009II: 77\u201354%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>TAPSE\/PASP ratio was associated with outcome in patients undergoing M-TEER for primary as well as secondary MR. RV\u2013PA coupling, alongside with TR severity, improved after M-TEER and might thus provide prognostic information in addition to established markers of poor outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00392-023-02318-w","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T11:01:29Z","timestamp":1698058889000},"page":"156-167","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Impact of right ventricular-to-pulmonary artery coupling on remodeling and outcome in patients undergoing transcatheter edge-to-edge mitral valve repair"],"prefix":"10.1007","volume":"114","author":[{"given":"Matthias","family":"Koschutnik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Don\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Nitsche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas A.","family":"Kammerlander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varius","family":"Dannenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Brunner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Koschatko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Mascherbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Heitzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kseniya","family":"Halavina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Spinka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max-Paul","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"H\u00fclsmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp E.","family":"Bartko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hengstenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Mascherbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Goliasch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,23]]},"reference":[{"key":"2318_CR1","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","volume":"43","author":"A Vahanian","year":"2022","unstructured":"Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, Capodanno D, Conradi L, De Bonis M, De Paulis R, Delgado V, Freemantle N, Gilard M, Haugaa KH, Jeppsson A, J\u00fcni P, Pierard L, Prendergast BD, S\u00e1daba JR, Tribouilloy C, Wojakowski W (2022) 2021 ESC\/EACTS guidelines for the management of valvular heart disease. 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Dannenberg received consulting fees from Abbott, and educational grants from Edwards Lifesciences. J. Mascherbauer received proctor fees from Abbott and Edwards Lifesciences, consulting fees from Boston Scientific, Edwards Lifesciences, and Shockwave Medical, and educational grants from Abbott, Boston Scientific, and Edwards Lifesciences. The remaining authors have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}