{"id":"df81f21d9d81","type":"article","url":"https://hartvaat.nl/2026/05/22/m-teer-werkt-over-het-volledige-lvef-spectrum-vergroot-linkeratrium-volume-voors/","title":"M-TEER werkt over het volledige LVEF-spectrum; vergroot linkeratrium-volume voorspelt slechtere uitkomst","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["mitraclip"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag149","source_url":"https://doi.org/10.1093/eschf/xvag149","authors":["Louise Rouleau","Marina Petersen Saadi","Adrien Al Wazzan","Prayuth Rasmeehirun","Guillaume L'official","Vincent Auffret","Guillaume Leurent","Emmanuel Oger","Erwan Donal"],"significance":5,"published":"2026-06-06","source_date":"2026-05-22","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/wat-is-hartfalen/","https://hartvaat.nl/kennis/hartfalen/hartfalen-stadiumindeling-nyha/"],"congress":"","summary_en":"Retrospective analysis of 93 consecutive patients with symptomatic secondary mitral regurgitation who underwent mitral transcatheter edge-to-edge repair (M-TEER) between 2018 and 2022. Composite clinical improvement (survival without HF hospitalisation, NYHA I-II, KCCQ >60) at 36 months was similar in reduced and preserved LVEF (51.8% vs 62.5%; p=0.32). Mortality was lower with preserved LVEF (9.4% vs 29.6%). Enlarged left atrial volume index (LAVI ≥60 mL/m²) was associated with higher mortality (29.4% vs 11.8%) and remained significant after adjustment. M-TEER thus delivers meaningful benefit across the LVEF spectrum, with left atrial enlargement marking advanced atrial disease and potentially supporting earlier intervention.","created":"2026-07-03T10:33:00Z","updated":"2026-07-03T13:31:55Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Retrospectieve analyse van 93 opeenvolgende patiënten met symptomatische secundaire mitralisinsufficiëntie die tussen 2018 en 2022 mitral transcatheter edge-to-edge repair (M-TEER) ondergingen. Klinische verbetering (overleving zonder hartfalen-opname, NYHA I-II, KCCQ >60) na 36 maanden was vergelijkbaar bij gereduceerde en behouden LVEF (51,8% vs 62,5%; p=0,32). Sterfte was lager bij behouden LVEF (9,4% vs 29,6%). Een vergroot linkeratrium-volume (LAVI ≥60 mL/m²) was geassocieerd met hogere mortaliteit (29,4% vs 11,8%) en bleef significant na correctie. M-TEER biedt dus zinvolle winst over het hele LVEF-spectrum, waarbij linkeratrium-vergroting een marker is van gevorderde atriale ziekte en mogelijk pleit voor eerdere interventie.","abstract_original":"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."}