{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:24:29Z","timestamp":1772958269270,"version":"3.50.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,4,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Pulmonary hypertension (PH) and secondary mitral regurgitation (MR) are associated with adverse outcomes after mitral transcatheter edge\u2010to\u2010edge repair. We aim to study the prognostic value of invasively measured right ventricular afterload in patients undergoing mitral transcatheter edge\u2010to\u2010edge repair.<\/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              We identified patients who underwent right heart catheterization \u22641 month before transcatheter edge\u2010to\u2010edge repair. The end points were all\u2010cause mortality and a composite of mortality and heart failure hospitalization at 2\u2009years. Using the receiver operating characteristic curve\u2013derived threshold of 0.6 for pulmonary effective arterial elastance ([Ea], pulmonary artery systolic pressure\/stroke volume), patients were stratified into 3 profiles based on PH severity (low elastance [HE]: Ea &lt;0.6\/mean pulmonary artery pressure (mPAP)) &lt;35; High Elastance with No\/Mild PH (HE\u2212): Ea \u22650.6\/mPAP &lt;35; and HE with Moderate\/Severe PH (HE+): Ea \u22650.6\/mPAP \u226535) and MR pathogenesis (Primary MR [PMR])\/low elastance, PMR\/HE, and secondary MR). The association between this classification and clinical outcomes was examined using Cox regression. Among 114 patients included, 50.9% had PMR. Mean\u00b1SD age was 74.7\u00b110.6\u2009years. Patients with Ea \u22650.6 were more likely to have diabetes, atrial fibrillation, New York Heart Association III\/IV status, and secondary MR (all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). Overall, 2\u2010year cumulative survival was 71.1% and was lower in patients with secondary MR and mPAP \u226535. Compared with patients with low elastance, cumulative 2\u2010year event\u2010free survival was significantly lower in HE\u2212 and HE+ patients (85.5% versus 50.4% versus 41.0%, respectively,\n              <jats:italic>P<\/jats:italic>\n              =0.001). Also, cumulative 2\u2010year event\u2010free survival was significantly higher in patients with PMR\/low elastance when compared with PMR\/HE and patients with secondary mitral regurgitation (85.5% versus 55.5% versus 46.1%, respectively,\n              <jats:italic>P<\/jats:italic>\n              =0.005).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Assessment of the preprocedural cardiopulmonary profile based on mPAP, MR pathogenesis, and Ea guides patient selection by identifying hemodynamic features that indicate likely benefit from mitral\u2010transcatheter edge\u2010to\u2010edge repair in PH or lack thereof.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.033510","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T10:04:11Z","timestamp":1712138651000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Prognostic Value of Right Ventricular Afterload in Patients Undergoing Mitral Transcatheter Edge\u2010to\u2010Edge Repair"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1953-5956","authenticated-orcid":false,"given":"Rody G.","family":"Bou Chaaya","sequence":"first","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6184-8314","authenticated-orcid":false,"given":"Taha","family":"Hatab","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2133-3106","authenticated-orcid":false,"given":"Sahar","family":"Samimi","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6035-5706","authenticated-orcid":false,"given":"Fatima","family":"Qamar","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2680-7047","authenticated-orcid":false,"given":"Chloe","family":"Kharsa","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6339-1630","authenticated-orcid":false,"given":"Joe","family":"Aoun","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadeen","family":"Faza","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5969-5543","authenticated-orcid":false,"given":"Stephen H.","family":"Little","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6619-5806","authenticated-orcid":false,"given":"Marvin D.","family":"Atkins","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Houston Methodist Hospital Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2880-6132","authenticated-orcid":false,"given":"Michael J.","family":"Reardon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Houston Methodist Hospital Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-8133","authenticated-orcid":false,"given":"Neal S.","family":"Kleiman","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4911-8056","authenticated-orcid":false,"given":"Sherif F.","family":"Nagueh","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center Houston 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