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. 2023 May;46(5):529-534.
doi: 10.1002/clc.24007. Epub 2023 Mar 22.

Deceleration capacity of heart rate predicts 1-year mortality in patients undergoing transcatheter edge-to-edge mitral valve repair

Lars Mizera  1 , Dominik Rath  1 , Jürgen Schreieck  1 , Peter Seizer  2 , Meinrad Paul Gawaz  1 , Martin Duckheim  1 , Christian Eick  1 , Karin A L Müller  1
Affiliations

Deceleration capacity of heart rate predicts 1-year mortality in patients undergoing transcatheter edge-to-edge mitral valve repair

Lars Mizera et al. Clin Cardiol. 2023 May.

Abstract

Background: Risk stratification for transcatheter procedures in patients with severe mitral regurgitation is challenging. Deceleration capacity (DC) has already proven to be a reliable risk predictor in patients undergoing transcatheter aortic valve implantation. We hypothesized, that DC provides prognostic value in patients undergoing transcatheter edge-to-edge mitral valve repair (TEER).

Methods: We retrospectively analyzed electrocardiogram signals from 106 patients undergoing TEER at the University Hospital of Tübingen. All patients received continuous heart-rate monitoring to assess DC following the procedure. One-year all-cause mortality was defined as the primary end point.

Results: Sixteen patients (15.1%) died within 1 year. The DC in nonsurvivors was significantly reduced compared to survivors (5.1 ± 3.0 vs. 3.0 ± 1.6 ms, p = 0.002). A higher EuroSCORE II and impaired left ventricular function were furthermore associated with poor outcome. In Cox regression analyses, a DC < 4.5 ms was found a strong predictor of 1-year mortality (hazard ratio: 0.10, 95% confidence interval: 0.13-0.79, p = 0.029). Finally, a significant negative correlation was found between DC and residual mitral regurgitation after TEER (r = -0.41, p < 0.001).

Conclusion: In patients with severe mitral regurgitation undergoing TEER, DC may serve as a new predictor of follow-up mortality.

Keywords: MitraClip; cardiac autonomic dysfunction; deceleration capacity; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Boxplots of deceleration capacity and residual mitral regurgitation after transcatheter edge‐to‐edge mitral valve repair.
Figure 2
Figure 2
Kaplan–Meier curves for cumulative survival according to deceleration capacity.
See this image and copyright information in PMC

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