Prognostic Impact of Mitral Valve Sphericity Index After Mitral Valve Transcatheter Edge-to-Edge Repair in Functional Mitral Regurgitation
Abstract
BACKGROUND: Changes in mitral valve (MV) morphology during MV transcatheter edge-to-edge repair (MV-TEER) are associated with short-term reduction of mitral regurgitation (MR). However, whether these changes are associated with prognosis remains unclear. Using 3-dimensional transesophageal echocardiography, this study evaluated the impact of MV morphological parameters on the mid-term prognosis of patients with functional MR (FMR). METHODS AND RESULTS: We analyzed 99 patients with FMR who were treated with MV-TEER. The primary endpoint was a composite of all-cause mortality and hospitalization due to heart failure. Patients were divided into 2 groups based on the post-procedural sphericity index of the mitral valve (SI-MV), which is the ratio of the vertical to horizontal MV diameter. Using receiver operating characteristic curve (ROC) analysis for the primary endpoint, the SI-MV cut-off value was determined to be 0.86. The incidence of the primary endpoint was significantly (log-rank P=0.013) higher among patients with a post-procedural SI-MV >0.86 (circular MV morphology) than among those with post-procedural SI-MV ≤0.86 (elliptical MV morphology). Post-procedural SI-MV >0.86 was an independent determinant of the primary endpoint in multivariate analysis (hazard ratio 2.35; 95% confidence interval 1.25-4.42; P=0.0077). CONCLUSIONS: A larger post-procedural SI-MV is associated with increased mid-term adverse clinical events after MV-TEER in patients with FMR.
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BibTeX
@article{kawamoto2026prognostic,
title = {{Prognostic Impact of Mitral Valve Sphericity Index After Mitral Valve Transcatheter Edge-to-Edge Repair in Functional Mitral Regurgitation}},
author = {Takanori Kawamoto and Chihiro Koyanagi and Yuichiro Minami and Yukako Tanaka and Masafumi Yoshikawa and Eiji Shibahashi and Kaoru Haruki and Risako Nakao and Yusuke Inagaki and Hisao Otsuki and Tomohito Kogure and Satoru Domoto and Kyomi Ashihara and Hiroshi Niinami and Junichi Yamaguchi},
journal = {Circulation Journal},
year = {2026},
month = aug,
doi = {10.1253/circj.cj-25-0457},
url = {https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-25-0457/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prognostic Impact of Mitral Valve Sphericity Index After Mitral Valve Transcatheter Edge-to-Edge Repair in Functional Mitral Regurgitation
AU - Takanori Kawamoto
AU - Chihiro Koyanagi
AU - Yuichiro Minami
AU - Yukako Tanaka
AU - Masafumi Yoshikawa
AU - Eiji Shibahashi
AU - Kaoru Haruki
AU - Risako Nakao
AU - Yusuke Inagaki
AU - Hisao Otsuki
AU - Tomohito Kogure
AU - Satoru Domoto
AU - Kyomi Ashihara
AU - Hiroshi Niinami
AU - Junichi Yamaguchi
PY - 2026
DA - 2026/08/25
JO - Circulation Journal
DO - 10.1253/circj.cj-25-0457
UR - https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-25-0457/_article
AB - BACKGROUND: Changes in mitral valve (MV) morphology during MV transcatheter edge-to-edge repair (MV-TEER) are associated with short-term reduction of mitral regurgitation (MR). However, whether these changes are associated with prognosis remains unclear. Using 3-dimensional transesophageal echocardiography, this study evaluated the impact of MV morphological parameters on the mid-term prognosis of patients with functional MR (FMR). METHODS AND RESULTS: We analyzed 99 patients with FMR who were treated with MV-TEER. The primary endpoint was a composite of all-cause mortality and hospitalization due to heart failure. Patients were divided into 2 groups based on the post-procedural sphericity index of the mitral valve (SI-MV), which is the ratio of the vertical to horizontal MV diameter. Using receiver operating characteristic curve (ROC) analysis for the primary endpoint, the SI-MV cut-off value was determined to be 0.86. The incidence of the primary endpoint was significantly (log-rank P=0.013) higher among patients with a post-procedural SI-MV >0.86 (circular MV morphology) than among those with post-procedural SI-MV ≤0.86 (elliptical MV morphology). Post-procedural SI-MV >0.86 was an independent determinant of the primary endpoint in multivariate analysis (hazard ratio 2.35; 95% confidence interval 1.25-4.42; P=0.0077). CONCLUSIONS: A larger post-procedural SI-MV is associated with increased mid-term adverse clinical events after MV-TEER in patients with FMR.
SN - 1347-4820
SN - 1346-9843
ER -