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Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure

Cardiology Department, University Hospital of Salamanca, Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
Cardiology Department, Alvaro Cunqueiro University Hospital, 36213 Vigo, Spain
Cardiology Department, Virgen de la Victoria University Hospital, Biomedical Research Institute of Málaga, 29010 Málaga, Spain
Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
Cardiology Department, University Hospital of Leon, 24071 Leon, Spain
Cardiology Department, University Hospital Santa Creu i Sant Pau, 08041 Barcelona, Spain
Cardiology Department, University Hospital Reina Sofia, University of Cordoba and Maimonides Institute for Biomedical Research (IMIBIC), 14004 Córdoba, Spain
Heart Area, Asturias Central University Hospital, University of Oviedo, Health Research Institute, 33011 Oviedo, Spain
Cardiovascular Institute, Hospital Clínico San Carlos, Health Research Institute San Carlos (IdISSC), 28040 Madrid, Spain
Cardiology Department, Clinic University Hospital of Valladolid, Heart Sciences Institute, 47003 Valladolid, Spain
Cardiology Department, Clínic University Hospital of Barcelona, University of Barcelona, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), 08041 Barcelona, Spain
Cardiology Department, Ramon y Cajal University Hospital, 28034 Madrid, Spain
Cardiology Department, Clinical University Hospital of Santiago, 15706 Santiago de Compostela, Spain
Cardiology Department, University Hospital of Basurto, 48013 Bilbao, Spain
Cardiology Department, University Hospital of Badajoz, 06080 Badajoz, Spain
Cardiology Department, General University Hospital of Valencia, 46014 Valencia, Spain
Cardiology Department, University Clinic Hospital of Valencia, University of Valencia, 46010 Valencia, Spain
Cardiology Department, University & Polytechnical Hospital La Fe, 46026 Valencia, Spain
Cardiology Department, University Hospital of Navarra, 31008 Pamplona, Spain
Cardiology Department, Regional University Hospital of Málaga, 29010 Málaga, Spain
Cardiology Department, University of Salamanca, 37008 Salamanca, Spain
Author to whom correspondence should be addressed.
Academic Editor: Giuseppe Santarpino
J. Clin. Med. 2021, 10(5), 1006;
Received: 13 January 2021 / Revised: 19 February 2021 / Accepted: 23 February 2021 / Published: 2 March 2021
Background: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has emerged as a relevant prognostic predictor in HF. In this study, we aimed to assess the prognostic value of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP) ratio as a non-invasive measure of RV-to-PA coupling in patients undergoing TMVR with MitraClip (Abbott, CA, USA). Methods: Multicentre registry including 228 consecutive patients that underwent successful TMVR with MitraClip. The sample was divided in two groups according to TAPSE/PASP median value: 0.35. The primary combined endpoint encompassed HF readmissions and all-cause mortality. Results: Mean age was 72.5 ± 11.5 years and 154 (67.5%) patients were male. HF readmissions and all-cause mortality were more frequent in patients with TAPSE/PASP ≤ 0.35: Log-Rank 8.844, p = 0.003. On Cox regression, TAPSE/PASP emerged as a prognostic predictor of the primary combined endpoint, together with STS-Score. TAPSE/PASP was a better prognostic predictor than either TAPSE or PASP separately. Conclusions: TAPSE/PASP ratio appears as a novel prognostic predictor in patients undergoing MitraClip implantation that might improve risk stratification and candidate selection. View Full-Text
Keywords: MitraClip; mitral valve repair; mitral valve regurgitation; pulmonary hypertension; right ventricular to pulmonary arterial coupling; transthoracic echocardiography MitraClip; mitral valve repair; mitral valve regurgitation; pulmonary hypertension; right ventricular to pulmonary arterial coupling; transthoracic echocardiography
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    Doi: 10.5281/zenodo.4436369
    Description: Supplementary Table 1.Supplementary Table 1. Baseline characteristics according to the combined endpoint. Supplementary Table 2. Procedural and 30-day outcomes according to the combined endpoint. Supplementary Table 3. Follow-up TAPSE/PASP ratio determinations after successful transcatheter mitral valve repair.
MDPI and ACS Style

Trejo-Velasco, B.; Estevez-Loureiro, R.; Carrasco-Chinchilla, F.; Fernández-Vázquez, F.; Arzamendi, D.; Pan, M.; Pascual, I.; Nombela-Franco, L.; Amat-Santos, I.J.; Freixa, X.; Hernández-Antolín, R.A.; Trillo-Nouche, R.; Andraka Ikazuriaga, L.; López-Mínguez, J.R.; Sanmiguel Cervera, D.; Sanchis, J.; Diez-Gil, J.L.; Ruiz-Quevedo, V.; Urbano-Carrillo, C.; Becerra-Muñoz, V.M.; Benito-González, T.; Li, C.H.; Mesa, D.; Avanzas, P.; Armijo, G.; Serrador-Frutos, A.M.; Sanchis, L.; Lobán, C.F.-G.; Cid-Álvarez, B.; Hernández-García, J.M.; Garrote-Coloma, C.; Fernández-Peregrina, E.; Romero, M.; León Arguero, V.; Cruz-González, I. Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure. J. Clin. Med. 2021, 10, 1006.

AMA Style

Trejo-Velasco B, Estevez-Loureiro R, Carrasco-Chinchilla F, Fernández-Vázquez F, Arzamendi D, Pan M, Pascual I, Nombela-Franco L, Amat-Santos IJ, Freixa X, Hernández-Antolín RA, Trillo-Nouche R, Andraka Ikazuriaga L, López-Mínguez JR, Sanmiguel Cervera D, Sanchis J, Diez-Gil JL, Ruiz-Quevedo V, Urbano-Carrillo C, Becerra-Muñoz VM, Benito-González T, Li CH, Mesa D, Avanzas P, Armijo G, Serrador-Frutos AM, Sanchis L, Lobán CF-G, Cid-Álvarez B, Hernández-García JM, Garrote-Coloma C, Fernández-Peregrina E, Romero M, León Arguero V, Cruz-González I. Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure. Journal of Clinical Medicine. 2021; 10(5):1006.

Chicago/Turabian Style

Trejo-Velasco, Blanca, Rodrigo Estevez-Loureiro, Fernando Carrasco-Chinchilla, Felipe Fernández-Vázquez, Dabit Arzamendi, Manuel Pan, Isaac Pascual, Luis Nombela-Franco, Ignacio J. Amat-Santos, Xavier Freixa, Rosa A. Hernández-Antolín, Ramiro Trillo-Nouche, Leire Andraka Ikazuriaga, José R. López-Mínguez, Dario Sanmiguel Cervera, Juan Sanchis, José L. Diez-Gil, Valeriano Ruiz-Quevedo, Cristóbal Urbano-Carrillo, Víctor M. Becerra-Muñoz, Tomás Benito-González, Chi H. Li, Dolores Mesa, Pablo Avanzas, Germán Armijo, Ana M. Serrador-Frutos, Laura Sanchis, Covadonga F.-G. Lobán, Belén Cid-Álvarez, José M. Hernández-García, Carmen Garrote-Coloma, Estefanía Fernández-Peregrina, Miguel Romero, Víctor León Arguero, and Ignacio Cruz-González. 2021. "Prognostic Role of TAPSE to PASP Ratio in Patients Undergoing MitraClip Procedure" Journal of Clinical Medicine 10, no. 5: 1006.

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