Left atrial remodeling and right ventricular-pulmonary arterial coupling after MitraClip implantation

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Transcatheter edge-to-edge mitral valve repair (TEER) with the MitraClip system has emerged as a therapeutic alternative to surgical solutions in high risk patients severe regurgitation (MR). MR is characterized by left ventricular volume overload, which leads dilatation. Furthermore, common cause pulmonary hypertension. Right (RV) intrinsic contractility and its response afterload referred RV-pulmonary arterial (PA) coupling. Effect TEER on atrial (LA) function RV-PA coupling less investigated. Purpose The aim our study was assess clinical characteristics undergoing implantation including LA Methods Eighty-eight consecutive chronic were enrolled single-center observational (mean age 71.5±7.9 years, male 54.5%, ischemic cardiomyopathy 54.5%). Primary (PMR) present 22.7%, secondary (SMR) 73.9 % mixed (MxMR) etiology 3.4%. Conventional advanced echocardiography examination performed using speckle tracking before at 6 month post-TEER follow-up. Left maximal (LAV max) minimal min) volumes measured indexed for body surface area. we analysed functional parameters, such reservoir strain, conduit strain contraction strain. Results technical success 95,5%. Mortality rate follow-up time 10.8% (1/88 PMR, 7/88 SMR, 1/88 MxMR). Severe residual developed during 4.2% New York Heart Association class III-IV status concluded 6.8% post-TEER. Significant decrease end-diastolic median diameter (mm) observed compared pre-TEER: 57.5 (IQR: 51.25 – 63.75) vs 60.5 52.5 66.75), respectively, p = 0.01. Similarly, value artery systolic pressure (PASP) substantially decreased (mmHg) after TEER: 42 32 52) 49.5 41 57), 0.003. Tricuspid annulus excursion/PASP value, representing coupling, improved remarkably: 0.45 0.31 0.69) 0.38 0.29 0.52), 0.02. Compared pre-TEER, parameters did not change significantly post-TEER: (%) 12.88 8.18–18.78) 11.74 7.48–20.36), 0.41; LAV max (ml) 48.70 39.81–62.29) 48.17 42.08–58.7), 0.31; min 34.33 24.5–46.32) 33.89 26.02–44.53), 0.69. Conclusions enlarged severely reduced, population. However, positive remodeling improvement procedure.