{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:28:35Z","timestamp":1793114915677,"version":"4.5.0"},"reference-count":26,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: The effective regurgitant orifice area to left ventricular end-diastolic volume (EROA\/LVEDV) ratio has been proposed to distinguish proportionate from disproportionate functional mitral regurgitation and to guide patient selection for transcatheter edge-to-edge repair (TEER). Methods: We conducted a multicenter, retrospective cohort study of 221 patients undergoing TEER with the Mitraclip system. Preprocedural echocardiographic parameters, including EROA, LVEDV, diastolic indices, and chamber volumes, were systematically collected. The primary outcome indicative of symptom worsening was defined as Heart Failure Hospitalizations (HFH) requiring IV diuresis\/death in the one year following clip placement. Association of the preprocedural EROA\/LVEDV ratio and symptom worsening was assessed using multivariate regression models and ROC-AUC. Results: In the one-year follow-up, 87 patients (39.36%) had symptom worsening. In the multivariate regression analysis, preprocedural EROA\/LVEDV ratio was associated with symptom worsening at one year (OR: 0.95 (0.92\u20130.97, p value &lt; 0.01). In the ROC model, the pre-procedural EROA\/LVEDV ratio had an AUC value of 0.74 (0.69\u20130.83), with a moderate value for predicting symptom worsening at one year. Conclusions: Results of the study proved that a lower pre-procedural EROA\/LVEDV ratio had a significant association with symptom worsening, with the ratio proving to have a moderate value for predicting symptom worsening\/death at one year.<\/jats:p>","DOI":"10.3390\/medicina62040795","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T10:38:14Z","timestamp":1776854294000},"page":"795","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Utility of EROA\/LVEDV Ratio in Mitraclip Outcomes: Retrospective Multicenter Cohort Study"],"prefix":"10.3390","volume":"62","author":[{"given":"Vivek Joseph","family":"Varughese","sequence":"first","affiliation":[{"name":"Department of Medicine, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9780-0448","authenticated-orcid":false,"given":"Chandler","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3140-8546","authenticated-orcid":false,"given":"James","family":"Pollock","sequence":"additional","affiliation":[{"name":"Department of Medicine, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patryk","family":"Czyzewski","sequence":"additional","affiliation":[{"name":"Department of Medicine, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Medicine, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hata","family":"Mujadzic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5109-0227","authenticated-orcid":false,"given":"Deborah M.","family":"Hurley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8703-7284","authenticated-orcid":false,"given":"Michael","family":"Cryer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Prisma Health, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil V.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2718-0606","authenticated-orcid":false,"given":"Akshay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1016\/j.jacc.2021.07.058","article-title":"Transcatheter mitral valve therapy in the United States: A report from the STS-ACC TVT Registry","volume":"78","author":"Mack","year":"2021","journal-title":"J. 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