Prognostic role of tapse to pasp ratio in patients undergoing mitraclip procedure

Dabit Arzamendi, Blanca Trejo-Velasco, Rodrigo Estevez-Loureiro, Fernando Carrasco-Chinchilla, Felipe Fernández-Vázquez, Manuel Pan Álvarez-Ossorio, Isaac Pascual, Luís Nombela-Franco, Ignacio J Amat-Santos, Xavier Freixa, Rosa Ana Hernández-Antolín, Ramiro Trillo-Nouche, L.A. Ikazuriaga, J.R. López-Mínguez, Dario Sanmiguel Cervera, Juan Sanchis, José Luís Diez-Gil, Valeriano Ruiz-Quevedo, Cristóbal A. Urbano-Carrillo, Víctor M. Becerra-MuñozTomás Benito-González, Chi Hion Li, Dolores Mesa, Pablo Avanzas, Germán Armijo, Ana María Serrador-Frutos, Laura Sanchis, Covadonga Fernández-Golfín, Belén Cid-Álvarez, José María Hernández-García, Carmen Garrote-Coloma, Estefanía Fernández-Peregrina, Miguel A. Romero, Víctor León Argüero, Ignacio Cruz-González

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17 Citations (Scopus)


Background: Transcatheter mitral valve repair (TMVR) is an effective therapy for high-risk patients with severe mitral regurgitation (MR) but heart failure (HF) readmissions and death remain substantial on mid-term follow-up. Recently, right ventricular (RV) to pulmonary arterial (PA) coupling has emerged as a relevant prognostic predictor in HF. In this study, we aimed to assess the prognostic value of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP) ratio as a non-invasive measure of RV-to-PA coupling in patients undergoing TMVR with MitraClip (Abbott, CA, USA). Methods: Multicentre registry including 228 consecutive patients that underwent successful TMVR with MitraClip. The sample was divided in two groups according to TAPSE/PASP median value: 0.35. The primary combined endpoint encompassed HF readmissions and all-cause mortality. Results: Mean age was 72.5 ± 11.5 years and 154 (67.5%) patients were male. HF readmissions and all-cause mortality were more frequent in patients with TAPSE/PASP ≤ 0.35: Log-Rank 8.844, p = 0.003. On Cox regression, TAPSE/PASP emerged as a prognostic predictor of the primary combined endpoint, together with STS-Score. TAPSE/PASP was a better prognostic predictor than either TAPSE or PASP separately. Conclusions: TAPSE/PASP ratio appears as a novel prognostic predictor in patients undergoing MitraClip implantation that might improve risk stratification and candidate selection.
Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalJournal of Clinical Medicine
Issue number5
Publication statusPublished - 2021


  • MitraClip
  • Mitral valve repair
  • Mitral valve regurgitation
  • Pulmonary hypertension
  • Right ventricular to pulmonary arterial coupling
  • Transthoracic echocardiography


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