journal article
LitStream Collection
Home
Messika-Zeitoun, David; Iung, Bernard; Baumgartner, Helmut
doi: 10.1093/eurheartj/ehae090pmid: 38380439
Graphical AbstractGraphical AbstractMR, mitral regurgitation; NOAC, non-vitamin K oral antagonist; SAVR, surgical aortic valve replacement; TAVI, transcatheter aortic valve implantation; VKA, vitamin K antagonist.
Maisano, Francesco; Hahn, Rebecca; Sorajja, Paul; Praz, Fabien; Lurz, Philipp
doi: 10.1093/eurheartj/ehae082pmid: 38426859
Graphical AbstractGraphical AbstractDisease stage and therapeutic strategies for tricuspid regurgitation. Tricuspid regurgitation evolves from undetectable early forms to advanced stages characterized by escalating symptoms, right heart failure, and organ impairment. While medical therapy is utilized throughout the disease course, its effectiveness wanes with progression. Surgery can play a role in the earlier stages, while transcatheter therapies are available for patients at high risk and in the more advanced stages of disease. Significant overlap between treatment options underscores the urgent need for precise, evidence-based protocols. Overall, early intervention is crucial to prevent organ damage and avoid futility of late treatments (smileys becoming sad). CAVI, caval valve implantation; RHF, right heart failure; TR, tricuspid regurgitation; RA, right atrial; RV, right ventricular; TTV, transcatheter tricuspid valve.
Muraru, Denisa; Badano, Luigi P; Hahn, Rebecca T; Lang, Roberto M; Delgado, Victoria; Wunderlich, Nina C; Donal, Erwan; Taramasso, Maurizio; Duncan, Alison; Lurz, Philipp; De Potter, Tom; Zamorano Gómez, José L; Bax, Jeroen J; von Bardeleben, Ralph Stephan; Enriquez-Sarano, Maurice; Maisano, Francesco; Praz, Fabien; Sitges, Marta
Bax, Jeroen J; Hahn, Rebecca T; Marsan, Nina Ajmone; Baumgartner, Helmut
doi: 10.1093/eurheartj/ehae050pmid: 38446449
Graphical AbstractGraphical AbstractCT, computed tomography.
Hausleiter, Jörg; Lachmann, Mark; Stolz, Lukas; Bedogni, Francesco; Rubbio, Antonio P; Estévez-Loureiro, Rodrigo; Raposeiras-Roubin, Sergio; Boekstegers, Peter; Karam, Nicole; Rudolph, Volker; ,
doi:
Showing 1 to 10 of 15 Articles
doi: 10.1093/eurheartj/ehae088pmid: 38441886
Graphical AbstractGraphical AbstractCharacteristic aspects of atrial vs. ventricular secondary tricuspid regurgitation and the possible overlapping features that may occur between the two typical phenotypes (the check mark means ‘presence of’; the tick means ‘absence of’). Depending on its etiology, some of the listed features of ventricular secondary tricuspid regurgitation may be absent in some patients (LVEF < 50%, left-sided VHD etc). CIED, cardiac implantable electronic device; ES, end-systolic; HD, heart disease; HFpEF, heart failure with preserved ejection fraction; HVD, heart valve disease; LVEF, left ventricular ejection fraction; PH, pulmonary hypertension; RA, right atrium; RV, right ventricle; TA, tricuspid annulus; TR, tricuspid regurgitation; TV, tricuspid valve.
Background and AimsRisk stratification for mitral valve transcatheter edge-to-edge repair (M-TEER) is paramount in the decision-making process to appropriately select patients with severe secondary mitral regurgitation (SMR). This study sought to develop and validate an artificial intelligence-derived risk score (EuroSMR score) to predict 1-year outcomes (survival or survival + clinical improvement) in patients with SMR undergoing M-TEER.MethodsAn artificial intelligence-derived risk score was developed from the EuroSMR cohort (4172 and 428 patients treated with M-TEER in the derivation and validation cohorts, respectively). The EuroSMR score was validated and compared with established risk models.ResultsThe EuroSMR risk score, which is based on 18 clinical, echocardiographic, laboratory, and medication parameters, allowed for an improved discrimination of surviving and non-surviving patients (hazard ratio 4.3, 95% confidence interval 3.7–5.0; P < .001), and outperformed established risk scores in the validation cohort. Prediction for 1-year mortality (area under the curve: 0.789, 95% confidence interval 0.737–0.842) ranged from <5% to >70%, including the identification of an extreme-risk population (2.6% of the entire cohort), which had a very high probability for not surviving beyond 1 year (hazard ratio 6.5, 95% confidence interval 3.0–14; P < .001). The top 5% of patients with the highest EuroSMR risk scores showed event rates of 72.7% for mortality and 83.2% for mortality or lack of clinical improvement at 1-year follow-up.ConclusionsThe EuroSMR risk score may allow for improved prognostication in heart failure patients with severe SMR, who are considered for a M-TEER procedure. The score is expected to facilitate the shared decision-making process with heart team members and patients.