{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:36Z","timestamp":1787008716868,"version":"build-2736575974"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Edwards Life Sciences"},{"DOI":"10.13039\/100019341","name":"Medtronic Japan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016242","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016242","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Abbott Medical Japan"},{"DOI":"10.13039\/501100002336","name":"Daiichi-Sankyo Company","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002336","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Mitral transcatheter edge-to-edge repair (M-TEER) is an established therapy for functional mitral regurgitation (FMR) and reduced left ventricular ejection fraction (LVEF). Although guideline-directed medical therapy (GDMT) is ideally optimized before M-TEER, this procedure may facilitate early post-procedural GDMT changes. However, the clinical impact of early in-hospital GDMT modifications remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed 1638 patients with FMR and LVEF &amp;lt;50% enrolled in a multicentre Japanese registry. The patients were stratified according to the number of GDMT classes prescribed at discharge (single [n = 183]; double [n = 505]; triple [n = 630]; quadruple [n = 320]). Changes from before M-TEER to discharge were categorized as increased (n = 271), unchanged (n = 1219), or decreased (n = 148). Associations between GDMT patterns and subsequent outcomes were evaluated. The primary endpoint was a composite of all-cause mortality and heart failure rehospitalization at 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Primary endpoints were achieved in 357 patients (22%). Event rates decreased across groups (single, 32%; double, 24%; triple, 21%; quadruple, 14%; P &amp;lt; 0.001). After adjusting for confounders, a greater number of GDMT classes at discharge independently predicted better prognosis (hazard ratio [HR]: 0.83; 95% confidence interval [CI]: 0.73\u20130.95), whereas pre-M-TEER GDMT was not significant. Compared with decreased GDMT, an unchanged status was not associated with improved outcomes, while an increased status significantly improved prognosis (HR 0.62, 95% CI 0.39\u20130.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with FMR and LVEF &amp;lt;50%, a higher number of GDMT classes at discharge and in-hospital uptitration of the GDMT class were associated with better outcomes, suggesting that early post-procedural GDMT optimization warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag005","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:17:34Z","timestamp":1769422654000},"page":"70-81","source":"Crossref","is-referenced-by-count":3,"title":["Clinical impact of early changes in guideline-directed medical therapy after mitral valve transcatheter edge-to-edge repair"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5653-4843","authenticated-orcid":false,"given":"Ayano","family":"Yoshida","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine , 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-6382","authenticated-orcid":false,"given":"Masanori","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Toyohashi Heart Center , Toyohashi ,","place":["Japan"]},{"name":"Department of Cardiology, Gifu Heart Center , Gifu ,","place":["Japan"]},{"name":"Department of Cardiology, Nagoya Heart Center , Nagoya 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