{
  "abstract": "Background: Secondary mitral regurgitation (SMR) contributes substantially to morbidity and mortality in heart failure. Mitral transcatheter edge-to-edge repair (M-TEER) improves outcomes in patients with reduced left ventricular ejection fraction (LVEF), but evidence in patients with preserved LVEF-often reflecting atrial functional mitral regurgitation-remains limited. Methods: We retrospectively analyzed 93 consecutive patients with symptomatic SMR treated with M-TEER between 2018 and 2022. Patients were stratified according to LVEF (<50% vs ≥50%) and left atrial volume index (LAVI <60 vs ≥60 mL/m2). The primary endpoint was comprehensive clinical improvement at 36 months, defined as survival without heart-failure hospitalization, New York Heart Association (NYHA) class I-II, and Kansas City Cardiomyopathy Questionnaire (KCCQ) score >60. Kaplan-Meier and Cox proportional hazards analyses were performed. Results: Among 87 patients with complete follow-up, 48 (55%) achieved the composite endpoint. Clinical improvement rates were similar in patients with reduced and preserved LVEF (51.8% vs 62.5%, p=0.32). All-cause mortality at 36 months was lower in preserved compared with reduced LVEF (9.4% vs 29.6%; log-rank p=0.03). Enlarged left atrial volume (LAVI ≥60 mL/m2) was associated with increased mortality (29.4% vs 11.8%; log-rank p=0.04). In Cox regression analyses adjusted for age and sex, LAVI remained associated with mortality risk. Conclusion: M-TEER provides sustained clinical benefit across the LVEF spectrum, including patients with preserved LVEF. Left atrial enlargement identifies patients with worse prognosis and may represent a marker of advanced atrial disease supporting earlier intervention.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "name": "Louise Rouleau"
    },
    {
      "name": "Marina Petersen Saadi"
    },
    {
      "name": "Adrien Al Wazzan"
    },
    {
      "name": "Prayuth Rasmeehirun"
    },
    {
      "name": "Guillaume L'Official"
    },
    {
      "name": "Vincent Auffret"
    },
    {
      "name": "Guillaume Leurent"
    },
    {
      "name": "Emmanuel Oger"
    },
    {
      "name": "Erwan Donal"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5cef94faz5809.bib",
  "cited_by": 0,
  "doi": "10.1093/eschf/xvag149",
  "fulltext_url": null,
  "id": "5cef94faz5809",
  "issns": [
    "2055-5822"
  ],
  "landing_url": "https://hal.science/hal-05648193v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.ib"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7162128048",
  "pdf_url": "https://hal.science/hal-05648193/document",
  "pmcid": null,
  "pmid": "42172671",
  "published": "2026-10-13",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/5cef94faz5809.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:55Z",
      "native_id": "hal-05648193",
      "source": "hal",
      "url": "https://hal.science/hal-05648193v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:1.sdv.ib",
      "subfield": "systems-synthetic"
    }
  ],
  "title": "Left Ventricular Function and Atrial Remodeling Shape Outcomes After Mitral-Transcatheter Edge-to-Edge Repair",
  "title_text": "Left Ventricular Function and Atrial Remodeling Shape Outcomes After Mitral-Transcatheter Edge-to-Edge Repair",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:55Z",
  "url": "https://research.draconitic.com/paper/5cef94faz5809",
  "venue": "ESC Heart Failure",
  "versions": []
}