{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:05:12Z","timestamp":1778814312289,"version":"3.51.4"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The association, if any, between the transmitral mean pressure gradient (TMPG) after mitral transcatheter edge-to-edge repair and 1-year mortality is controversial in patients undergoing mitral transcatheter edge-to-edge repair with the MitraClip system. We sought to estimate the association between intraoperatively measured residual mitral regurgitation (rMR) and TMPG and 1-year mortality among patients undergoing mitral transcatheter edge-to-edge repair to facilitate decisions on additional devices.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>In patients with severe secondary (functional) MR, we analyzed registry data using generalized estimating equations. Both rMR and TMPG were nonlinearly transformed using fractional polynomials.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              We studied 570 patients with secondary MR who underwent mitral transcatheter edge-to-edge repair in 11 centers. Most patients were men (61%) and averaged 72\u00b112 years of age. Most (78%) patients had TMPG &lt;5 mm\u2005Hg and 22% had TMPG \u22655 mm\u2005Hg. Postprocedural MR severity improved substantially, being \u22642+ in 95% (with \u22641+ in 76%), 3+ in 3%, and 4+ in 2%. 1-year mortality was 20%. After adjustment for confounders, rMR (odds ratio, 2.10 [95% CI, 1.88\u20132.35];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001 for rMR\n              <jats:sup>.5<\/jats:sup>\n              ) and TMPG remained associated with mortality, with odds ratios of 1.26 (95% CI, 1.19\u20131.32), 1.84 (1.58\u20132.10), and 3.13 (2.31\u20133.98) for TMPG values of 4, 6, and 8, respectively, compared with TMPG=2 mm\u2005Hg at rMR=1+.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Both rMR and TMPG were nonlinearly associated with 1-year mortality. At low levels of rMR, changes in TMPG are associated with only small changes in the risk of death. Conversely, at higher levels of rMR, even small changes in TMPG are associated with larger changes in the absolute risk of death.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.124.014843","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T10:00:22Z","timestamp":1738058422000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Residual Mitral Regurgitation Interacts With Transmitral Mean Pressure Gradient to Modify the Association With Mortality Following Transcatheter Edge-to-Edge Repair"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7147-8023","authenticated-orcid":true,"given":"Neal M.","family":"Duggal","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor (N.M.D., M.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3367-1906","authenticated-orcid":true,"given":"Milo","family":"Engoren","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor (N.M.D., M.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6401-854X","authenticated-orcid":true,"given":"Paul","family":"Sorajja","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute, Abbott Northwestern Medical Center, MN (P.S., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-6660","authenticated-orcid":true,"given":"D. Scott","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Virginia, Charlottesville (D.S.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason H.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of California Davis Medical Center, Sacramento (J.H.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott M.","family":"Chadderdon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Oregon Health and Science University, Portland (S.M.C., F.E.Z.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8448-8880","authenticated-orcid":true,"given":"Firas E.","family":"Zahr","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Oregon Health and Science University, Portland (S.M.C., F.E.Z.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelio","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Ascension Saint Thomas Heart, Nashville, TN (E.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2003-0891","authenticated-orcid":true,"given":"M. Andrew","family":"Morse","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ascension Saint Thomas Heart, Nashville, TN (M.A.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"Garcia-Sayan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, TX (E.G.-S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishtha","family":"Sodhi","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute, Abbott Northwestern Medical Center, MN (P.S., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4708-389X","authenticated-orcid":true,"given":"Marcella A.","family":"Calfon Press","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of California Los Angeles (M.A.C.P.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-4726","authenticated-orcid":true,"given":"Gorav","family":"Ailawadi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University of Michigan, Ann Arbor (G.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000932"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.02.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.4244\/eijv4i4a76"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806640"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.053061"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1774"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.049"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.12.020"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2019.01.003"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.046"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2021.05.017"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.12.007"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.12.015"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.03.050"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.01.373"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.12.280"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011366"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.01.049"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.01.281"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jead011"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2024.05.018"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.09.050"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.02.018"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.11.007"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.124.014843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T17:28:48Z","timestamp":1745861328000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.124.014843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.124.014843"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.124.014843","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-10-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}