ArticleEchocardiography (Mount Kisco, N.Y.)2026
Prognostic Value of Prolapse Width for Mid-Term Degenerative Mitral Regurgitation Stability After Transcatheter Edge-to-Edge Repair.
Article in Echocardiography (Mount Kisco, N.Y.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04734756 (A Prospective, Multicenter, Objective Performance Criteria Study to Evaluate the Safety and Effectiveness of Dragonfly Transcatheter Mitral Valve Repair System for the Treatment of Degenerative Mitral Regurgitation), which is not on this map. Not yet cited in PubMed.
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A Prospective, Multicenter, Objective Performance Criteria Study to Evaluate the Safety and Effectiveness of Dragonfly Transcatheter Mitral Valve Repair System for the Treatment of Degenerative Mitral Regurgitation (DMR) Subjects.
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Abstract
backgroundLong-term durability of degenerative mitral regurgitation (DMR) reduction after transcatheter edge-to-edge repair (TEER) remains limited, and reliable anatomical predictors are still lacking.
methodsThis study prospectively enrolled patients with symptomatic DMR undergoing TEER across 27 centers in China. All pre-procedural clinical and echocardiographic parameters were collected and analyzed. The primary outcome was MR ≤ 1+ at 3-year follow-up. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify predictors and optimal cutoff values.
resultsA total of 78 patients with available 3-year echocardiographic assessments were included in the imaging-based analysis (mean age, 74.4 ± 5.1 years; 67.9% with NYHA class III/IV symptoms; mean STS score for mitral valve replacement, 6.8 ± 2.7%). At 3-year follow-up, 49 patients (62.8%) maintained MR ≤1+. TEER was associated with significant reverse cardiac remodeling, including reductions in left ventricular end-diastolic volume (125.4 ± 40.6 to 99.8 ± 19.7 mL) and pulmonary artery systolic pressure (43.0 ± 11.6 to 34.3 ± 11.4 mmHg) (both p < 0.001), while LVEF remained stable. Mitral valve (MV) prolapse/flail width independently predicted MR durability (OR: 0.789; 95% CI: 0.655-0.951; p = 0.013). ROC analysis identified a cutoff value of 16 mm (AUC: 0.714; p = 0.002), with patients having prolapse/flail width ≥16 mm demonstrating lower rates of MR ≤1+ at 3 years.
conclusionsPre-procedural prolapse/flail width is an independent predictor of 3-year MR durability after TEER in patients with DMR. Larger prolapse/flail width is associated with reduced mid-term MR stability, suggesting its potential value for risk stratification and procedural planning.
trial registrationThis study has been registered at ClinicalTrials.gov with a number of NCT04734756.
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