{
  "abstract": "Background: In patients with primary mitral regurgitation (MR) (PMR), advanced symptoms classified as New York Heart Association (NYHA) class IV are typically driven by valve deterioration. Transcatheter edge-to-edge repair (mitral valve transcatheter edge-to-edge repair [M-TEER]) reliably achieves effective reduction of mitral regurgitation in high-risk patients. However, whether or not preprocedural NYHA class IV continues to predict outcomes after successful MR reduction remains unclear. Methods: The Outcomes of Patients tReated wIth Mitral Transcatheter Edge-to-edge Repair for Primary Mitral Regurgitation Registry includes PMR patients undergoing M-TEER at 27 international sites between 2009 and 2023. Clinical outcomes were compared between patients in NYHA class IV and those in NYHA class II/III. Results: A total of 2528 patients were included (median age 82 years [interquartile range (IQR) 76-85], 45.9% female), and 19.7% presented in NYHA class IV. Baseline left ventricular ejection fraction and right ventricular function did not differ significantly between groups. Procedural success (residual MR <= 1+: 66.7% vs. 64.6%, p = 0.55) and 2-year rehospitalization rates (17.9% vs. 20.4%, log-rank p = 0.78) were comparable. In contrast, 2-year all-cause mortality was higher in NYHA class IV patients (31.8% vs. 21.1%, log-rank p < 0.0001). Multivariable Cox regression confirmed preprocedural NYHA class IV as an independent predictor of mortality (hazard ratio [HR] 1.75; 95% CI 1.32-2.31; p < 0.001). Conclusions: In PMR, preprocedural NYHA class IV remains an independent predictor of all-cause mortality after effective MR reduction with M-TEER, despite comparable postprocedural results.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 42,
  "authors": [
    {
      "name": "Benedikt Koell"
    },
    {
      "name": "Lydia Plewe"
    },
    {
      "name": "Sebastian Ludwig"
    },
    {
      "name": "Jessica Weimann"
    },
    {
      "name": "Dhairya Patel"
    },
    {
      "name": "Lukas Stolz"
    },
    {
      "name": "Tetsu Tanaka"
    },
    {
      "name": "Teresa Trenkwalder"
    },
    {
      "name": "Felix Rudolph"
    },
    {
      "name": "Daryoush Samim"
    },
    {
      "name": "Philipp von Stein"
    },
    {
      "name": "Cristina Giannini"
    },
    {
      "name": "Julien Dreyfus"
    },
    {
      "name": "Andrea Scotti"
    },
    {
      "name": "Jean-Michel Paradis"
    },
    {
      "name": "Marianna Adamo"
    },
    {
      "name": "Nicole Karam"
    },
    {
      "name": "Yohann Bohbot"
    },
    {
      "name": "Anne Bernard"
    },
    {
      "name": "Bruno Melica"
    },
    {
      "name": "Yusuke Kobari"
    },
    {
      "name": "Yoan Lavie-Badie"
    },
    {
      "name": "Mirjam Kessler"
    },
    {
      "name": "Omar Chehab"
    },
    {
      "name": "Simon Redwood"
    },
    {
      "name": "Edith Lubos"
    },
    {
      "name": "Ole de Baker"
    },
    {
      "name": "Marco Metra"
    },
    {
      "name": "Azeem Latib"
    },
    {
      "name": "Chiara Primerano"
    },
    {
      "name": "Christos Iliadis"
    },
    {
      "name": "Fabien Praz"
    },
    {
      "name": "Muhammed Gerçek"
    },
    {
      "name": "Erion Xhepa"
    },
    {
      "name": "Marcel Weber"
    },
    {
      "name": "Raj Makkar"
    },
    {
      "name": "Juan Granada"
    },
    {
      "name": "Thomas Modine"
    },
    {
      "name": "Erwan Donal"
    },
    {
      "name": "Jörg Hausleiter"
    },
    {
      "name": "Augustin Coisne"
    },
    {
      "name": "Daniel Kalbacher"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1n59sggwrx131.bib",
  "cited_by": 0,
  "doi": "10.1016/j.shj.2026.101053",
  "fulltext_url": null,
  "id": "1n59sggwrx131",
  "issns": [
    "2474-8706"
  ],
  "landing_url": "https://hal.science/hal-05730438v1",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "hal",
      "2.sdv.mhep.csc"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7162104197",
  "pdf_url": "https://hal.science/hal-05730438/document",
  "pmcid": null,
  "pmid": "42491144",
  "published": "2026-10-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1n59sggwrx131.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:01Z",
      "native_id": "hal-05730438",
      "source": "hal",
      "url": "https://hal.science/hal-05730438v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    },
    {
      "field": "medicine",
      "origin": "hal:2.sdv.mhep.csc",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Preprocedural New York Heart Association Class IV Independently Predicts Mortality After Effective Edge-To-Edge Repair for Primary Mitral Regurgitation",
  "title_text": "Preprocedural New York Heart Association Class IV Independently Predicts Mortality After Effective Edge-To-Edge Repair for Primary Mitral Regurgitation",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:01Z",
  "url": "https://research.draconitic.com/paper/1n59sggwrx131",
  "venue": "Structural Heart",
  "versions": []
}