{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T05:55:55Z","timestamp":1793858155916,"version":"4.6.1"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,7,4]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Little is known about the impact of transcatheter mitral valve edge\u2010to\u2010edge repair on changes in left ventricular ejection fraction (LVEF) and the effect of an acute reduction in LVEF on prognosis. We aimed to assess changes in LVEF after transcatheter mitral valve edge\u2010to\u2010edge repair for both primary and secondary mitral regurgitation (PMR and SMR, respectively), identify rates and predictors of LVEF reduction, and estimate its impact on prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In this international multicenter registry, patients with both PMR and SMR undergoing transcatheter mitral valve edge\u2010to\u2010edge repair were included. We assessed rates of acute LVEF reduction (LVEFR), defined as an acute relative decrease of &gt;15% in LVEF, its impact on all\u2010cause mortality, major adverse cardiac event (composite end point of all\u2010cause death, mitral valve surgery, and residual mitral regurgitation grade \u22652), and LVEF at 12\u2009months, as well as predictors for LVEFR. Of 2534 patients included (727 with PMR, and 1807 with SMR), 469 (18.5%) developed LVEFR. Patients with PMR were older (79.0\u00b19.2 versus 71.8\u00b18.9\u2009years;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and had higher mean LVEF (54.8\u00b114.0% versus 32.7\u00b110.4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) at baseline. After 6 to 12\u2009months (median, 9.9 months; interquartile range, 7.8\u201311.9 months), LVEF was significantly lower in patients with PMR (53.0% versus 56.0%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) but not in patients with SMR. The 1\u2010year mortality was higher in patients with PMR with LVEFR (16.9% versus 9.7%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) but not in those with SMR (\n                      <jats:italic>P<\/jats:italic>\n                      =0.236). LVEF at baseline (odds ratio, 1.03 [95% CI, 1.01\u20131.05];\n                      <jats:italic>P<\/jats:italic>\n                      =0.002) was predictive of LVEFR for patients with PMR, but not those with SMR (\n                      <jats:italic>P<\/jats:italic>\n                      =0.092).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Reduction in LVEF is not uncommon after transcatheter mitral valve edge\u2010to\u2010edge repair and is correlated with worsened prognosis in patients with PMR but not patients with SMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\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: NCT05311163.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.029735","type":"journal-article","created":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T20:34:19Z","timestamp":1687466059000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Acute Reduction in Left Ventricular Function Following Transcatheter Mitral Edge\u2010to\u2010Edge Repair"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-7937","authenticated-orcid":false,"given":"Leor","family":"Perl","sequence":"first","affiliation":[{"name":"Division of Cardiology, Rabin Medical Center\u2013Beilinson Hospital, Petah\u2010Tikva, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7735-4419","authenticated-orcid":false,"given":"Mark","family":"Kheifets","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Rabin Medical Center\u2013Beilinson Hospital, Petah\u2010Tikva, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7727-0573","authenticated-orcid":false,"given":"Ascione","family":"Guido","sequence":"additional","affiliation":[{"name":"Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4834-2187","authenticated-orcid":false,"given":"Eustachio","family":"Agricola","sequence":"additional","affiliation":[{"name":"Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3075-0203","authenticated-orcid":false,"given":"Paolo","family":"Denti","sequence":"additional","affiliation":[{"name":"Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3626-3876","authenticated-orcid":false,"given":"Mirjam Gauri","family":"Wild","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg\/Bad Krozingen Bad Krozingen Germany"},{"name":"Department of Cardiology, Bern University Hospital University of Bern Bern, 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