{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:18:14Z","timestamp":1793398694602,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2021,8,10]]},"abstract":"\n Background:<\/jats:title>\n In the randomized COAPT trial (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation), among 614 patients with heart failure with 3+ or 4+ secondary mitral regurgitation (MR), transcatheter mitral valve repair (TMVr) with the MitraClip reduced MR, heart failure hospitalizations, and mortality and improved quality of life compared with guideline-directed medical therapy (GDMT) alone. We aimed to examine the prognostic relationship between MR reduction and outcomes after TMVr and GDMT alone.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Outcomes in COAPT between 30 days and 2 years were examined on the basis of the severity of residual MR at 30 days.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n TMVr-treated patients had less severe residual MR at 30 days than GDMT-treated patients (0\/1+, 2+, and 3+\/4+: 72.9%, 19.9%, and 7.2% versus 8.2%, 26.1%, and 65.8%, respectively [\n P<\/jats:italic>\n <0.0001]). The rate of composite death or heart failure hospitalizations between 30 days and 2 years was lower in patients with 30-day residual MR of 0\/1+ and 2+ compared with patients with 30-day residual MR of 3+\/4+ (37.7% versus 49.5% versus 72.2%, respectively [\n P<\/jats:italic>\n <0.0001]). This relationship was consistent in the TMVr and GDMT arms (\n P<\/jats:italic>\n interaction<\/jats:sub>\n =0.92). The improvement in Kansas City Cardiomyopathy Questionnaire score from baseline to 30 days was maintained between 30 days and 2 years in patients with 30-day MR \u22642+ but deteriorated in those with 30-day MR 3+\/4+ (\u20130.3\u00b11.7 versus \u20139.4\u00b14.6 [\n P<\/jats:italic>\n =0.0008]) consistently in both groups (\n P<\/jats:italic>\n interaction<\/jats:sub>\n =0.95).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In the COAPT trial, reduced MR at 30 days was associated with greater freedom from death or heart failure hospitalizations and improved quality of life through 2-year follow-up whether the MR reduction was achieved by TMVr or GDMT.<\/jats:p>\n <\/jats:sec>\n \n Registration:<\/jats:title>\n \n URL:\n https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n ; Unique identifier: NCT01626079.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/circulationaha.120.053061","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T05:05:37Z","timestamp":1622091937000},"page":"426-437","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":121,"title":["Relationship Between Residual Mitral Regurgitation and Clinical and Quality-of-Life Outcomes After Transcatheter and Medical Treatments in Heart Failure"],"prefix":"10.1161","volume":"144","clinical-trial-number":[{"clinical-trial-number":"nct01626079","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Saibal","family":"Kar","sequence":"first","affiliation":[{"name":"Los Robles Regional Medical Center, Thousand Oaks, CA (S.K.)."},{"name":"Bakersfield Heart Hospital, CA (S.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Mack","sequence":"additional","affiliation":[{"name":"Baylor Scott & White Heart Hospital Plano, TX (M.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnn","family":"Lindenfeld","sequence":"additional","affiliation":[{"name":"Advanced Heart Failure and Cardiac Transplantation Section, Vanderbilt Heart and Vascular Institute, Nashville, TN (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4805-1037","authenticated-orcid":true,"given":"William T.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, The Ohio State University, Columbus (W.T.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico M.","family":"Asch","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Washington, DC (F.M.A., N.J.W.)."},{"name":"Georgetown University, Washington, DC (F.M.A., N.J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil J.","family":"Weissman","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Washington, DC (F.M.A., N.J.W.)."},{"name":"Georgetown University, Washington, DC (F.M.A., N.J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0910-5450","authenticated-orcid":true,"given":"Maurice","family":"Enriquez-Sarano","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN (M.E.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Scott","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Virginia, Charlottesville (D.S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M.","family":"Mishell","sequence":"additional","affiliation":[{"name":"Kaiser Permanente\u2013San Francisco Hospital, CA (J.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian K.","family":"Whisenant","sequence":"additional","affiliation":[{"name":"Intermountain Heart Center, Salt Lake City, UT (B.K.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason H.","family":"Rogers","sequence":"additional","affiliation":[{"name":"University of California Davis Medical Center, Sacramento (J.H.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne V.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"University of Missouri\u2013Kansas City School of Medicine (S.V.A.)."},{"name":"St Francis Hospital, Roslyn, NY (D.J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Grayburn","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center, Baylor Heart and Vascular Institute, Dallas, TX (P.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3416-8210","authenticated-orcid":true,"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (D.J.C., G.W.S.)."},{"name":"The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (G.W.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2011.225789"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9149(02)03301-5"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805374"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806640"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1616"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.017"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa129"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.11.112"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.11.006"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1774"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12376"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2014-000056"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.09.099"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28029"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602003"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.120.053061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T03:54:49Z","timestamp":1715572489000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.120.053061"}},"subtitle":["COAPT Trial"],"short-title":[],"issued":{"date-parts":[[2021,8,10]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,8,10]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.120.053061"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.120.053061","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.740190486.793586533","asserted-by":"object"}]},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,10]]},"assertion":[{"value":"2020-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}