{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:13:31Z","timestamp":1788174811079,"version":"build-2803163510"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Percutaneous mitral valve repair (PMVR) provides an available choice for patients suffering from secondary mitral regurgitation (SMR), especially those whose symptoms persist after optimal, conventional, heart-failure therapy. However, conflicting results from clinical trials have created a problem in identifying patients who will benefit the most from PMVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To pool mortality data and assess clinical predictors after PMVR among patients with SMR. To this end, subgroup and meta-regression analyses were additionally performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, EMBASE, and Cochrane databases, and 13 studies were finally included for meta-analysis. Estimated mortality and 95% confidence intervals (CIs) were obtained using a random-effects proportional meta-analysis. We also carried out a meta-regression analysis to clarify the potential influence of important covariates on mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,259 patients with SMR who had undergone PMVR were enrolled in our meta-analysis. The long-term estimated pooled mortality of PMVR was 19.3% (95% CI: 13.6\u201325.1). Meta-regression analysis showed that mortality was directly proportional to cardiac resynchronization therapy (CRT) (\u03b2 = 0.009; 95% CI: 0.002\u20130.016; <jats:italic>p<\/jats:italic> = 0.009), an effective regurgitant orifice (ERO) (\u03b2 = 0.009; 95% CI: 0.000\u20130.018; <jats:italic>p<\/jats:italic> = 0.047), and a mineralocorticoid receptor antagonist (MRA) use (\u03b2 = \u22120.015; 95% CI: \u22120.023\u2013\u22120.006; <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Subgroup analysis indicated that patients with preexisting AF (\u03b2 = \u22120.002; 95% CI: \u22120.005\u2013 \u22120.000; <jats:italic>p<\/jats:italic> = 0.018) were associated with decreased mortality if they received a mitral annuloplasty device. Among the edge-to-edge repair device group, a higher left ventricular (LV) ejection fraction, or lower LV end-systolic diameter, LV end-systolic volume, and LV end-diastolic volume were proportional to lower mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and Relevance<\/jats:title><jats:p>The pooled mortality of PMVR was 19.3% (95% CI: 13.6\u201325.1). Further meta-regression indicated that AF was associated with a better outcome in conjunction with the use of a mitral annuloplasty device, while better LV functioning predicted a better outcome after the implantation of an edge-to-edge repair device.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.918712","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T06:26:54Z","timestamp":1656916014000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Mortality and Clinical Predictors After Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Regression Analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Wence","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenchang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojie","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunhua","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1001\/jamacardio.2017.2976","article-title":"Survival and cardiovascular outcomes of patients with secondary mitral regurgitation: a systematic review and meta-analysis 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