{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:39:50Z","timestamp":1789832390008,"version":"4.0.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The extent of cardiac damage and its association with clinical outcomes in patients undergoing transcatheter edge-to-edge repair (TEER) for degenerative mitral regurgitation remains unclear. This study was aimed to investigate cardiac damage in patients with degenerative mitral regurgitation treated with TEER and its association with outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We analyzed patients with degenerative mitral regurgitation treated with TEER in the Optimized Catheter Valvular Intervention-Mitral registry, which is a prospective, multicenter observational data collection in Japan. The study subjects were classified according to the extent of cardiac damage at baseline: no extravalvular cardiac damage (stage 0), mild left ventricular or left atrial damage (stage 1), moderate left ventricular or left atrial damage (stage 2), or right heart damage (stage 3). Two-year mortality after TEER was compared using Kaplan-Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Out of 579 study participants, 8 (1.4%) were classified as stage 0, 76 (13.1%) as stage 1, 319 (55.1%) as stage 2, and 176 (30.4%) as stage 3. Two-year survival was 100% in stage 0, 89.5% in stage 1, 78.9% in stage 2, and 75.3% in stage 3 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.013). Compared with stage 0 to 1, stage 2 (hazard ratio, 3.34 [95% CI, 1.03\u201310.81];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.044) and stage 3 (hazard ratio, 4.51 [95% CI, 1.37\u201314.85];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.013) were associated with increased risk of 2-year mortality after TEER. Significant reductions in heart failure rehospitalization rate and New York Heart Association functional scale were observed following TEER (both,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), irrespective of the stage of cardiac damage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Advanced cardiac damage is associated with an increased risk of mortality in patients undergoing TEER for degenerative mitral regurgitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: UMIN000023653.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.123.013794","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T18:16:03Z","timestamp":1748542563000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Cardiac Damage in Degenerative Mitral Regurgitation Treated With Transcatheter Mitral Edge-to-Edge Repair"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"umin000023653","registry":"10.18810\/umin-japan"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9446-9963","authenticated-orcid":true,"given":"Atsushi","family":"Sugiura","sequence":"first","affiliation":[{"name":"Heart Center Bonn, Department of Internal Medicine II, University Hospital Bonn, Germany (A.S., G.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Toyohashi Heart Center, Japan (M. Yamamoto, Y.A.)."},{"name":"Department of Cardiology, Nagoya Heart Center, Japan (M. Yamamoto, Y.A.)."},{"name":"Department of Cardiology, Gifu Heart Center, Japan (M. Yamamoto)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-109X","authenticated-orcid":true,"given":"Mike","family":"Saji","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan (M.S.)."},{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2102-033X","authenticated-orcid":true,"given":"Masahiko","family":"Asami","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan (M. Asami)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1931-1012","authenticated-orcid":true,"given":"Yusuke","family":"Enta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sendai Kosei Hospital, Japan (Y.E., M.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5245-1573","authenticated-orcid":true,"given":"Masaki","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sendai Kosei Hospital, Japan (Y.E., M.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4764-8205","authenticated-orcid":true,"given":"Shinichi","family":"Shirai","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan (S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8597-1479","authenticated-orcid":true,"given":"Masaki","family":"Izumo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, St. Marianna University School of Medicine Hospital, Kawasaki, Japan (M.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan (S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2297-5303","authenticated-orcid":true,"given":"Yusuke","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan (Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Amaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan (M. Amaki)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhisa","family":"Kodama","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Japan (K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0967-0978","authenticated-orcid":true,"given":"Junichi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Woman\u2019s Medical University, Japan (J.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Japan (Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Naganuma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, New Tokyo Hospital, Chiba, Japan (T.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Bota","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sapporo Higashi Tokushukai Hospital, Japan (H.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4203-7613","authenticated-orcid":true,"given":"Yohei","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. Department of Cardiology (Y.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yamawaki","sequence":"additional","affiliation":[{"name":"Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan (M. Yamawaki)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9747-2511","authenticated-orcid":true,"given":"Hiroshi","family":"Ueno","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Toyama University Hospital, Japan (H.U.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7206-4538","authenticated-orcid":true,"given":"Kazuki","family":"Mizutani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, Osaka, Japan (K.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Adachi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Toyohashi Heart Center, Japan (M. Yamamoto, Y.A.)."},{"name":"Department of Cardiology, Nagoya Heart Center, Japan (M. Yamamoto, Y.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7994-7594","authenticated-orcid":true,"given":"Toshiaki","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan (T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kurashiki Central Hospital, Japan (S.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[{"name":"Heart Center Bonn, Department of Internal Medicine II, University Hospital Bonn, Germany (A.S., G.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1750-1982","authenticated-orcid":true,"given":"Kentaro","family":"Hayashida","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the OCEAN-Mitral Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60692-9"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30473-2"},{"key":"e_1_3_3_4_2","first-page":"e82","article-title":"2020 ACC\/AHA Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines.","volume":"143","author":"Otto CM","year":"2021","unstructured":"Otto, CM, Nishimura, RA, Bonow, RO, Carabello, BA, Erwin, JP, Gentile, F, Jneid, H, Krieger, EV, Mack, M, McLeod, C, et al. 2020 ACC\/AHA Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. 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