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. 2025 Jul 29.
doi: 10.1007/s00392-025-02712-6. Online ahead of print.

Targeted proteomic profiling of transcatheter edge-to-edge repair failure in patients with mitral regurgitation and heart failure

Mattia Di Pasquale  1 , Susana Ravassa  2 , Matteo Pagnesi  1 , Edoardo Pancaldi  1 , Begoña López  2 , Gorka San José  2 , Cristina Gussago  1 , Letizia Fiorentino  1 , Alice Ravera  1 , Lisa Serafini  1 , Giuliano Chizzola  1 , Carlo Mario Lombardi  1 , Marco Metra  1 , Arantxa González  2   3 , Marianna Adamo  4
Affiliations

Targeted proteomic profiling of transcatheter edge-to-edge repair failure in patients with mitral regurgitation and heart failure

Mattia Di Pasquale et al. Clin Res Cardiol. .

Abstract

Aims: To assess the changes in circulating biomarkers concentrations after mitral valve transcatheter edge-to-edge repair (M-TEER) and their relationship with procedural success vs. failure in patients with severe mitral regurgitation (MR) and heart failure (HF).

Methods and results: Pre-procedural, post-intervention, and 30 days post-intervention plasma samples were analyzed for 266 different proteins using the Olink Proseek® Multiplex cardiovascular (CVD) II, CVD III, and inflammation panels, in patients with MR undergoing M-TEER. Multiple biomarkers showed a differential expression 30 days after M-TEER in patients with procedural failure vs. those with a successful evolution. The proteins upregulated in patients with procedural failure were functionally enriched in pathways related to immune regulation, inflammation, extracellular matrix organization, and cellular structures. After adjustment for confounding variables, increases in IL2RA, RAGE, IGFBP2, and COL1A1 values at 30 days post-intervention were associated with procedural failure. Changes in IGFBP2 and IL2RA values were also independently associated with pulmonary artery systolic pressure (PASP) increases after M-TEER.

Conclusion: In a cohort of patients with severe MR undergoing M-TEER, differences in circulating biomarkers concentrations related to inflammation and fibrosis were observed between patients with procedural success as compared to those with procedural failure. Biomarkers known to be associated with HF severity were over-expressed in patients with procedural failure, compared with those with procedural success, after M-TEER.

Keywords: Biomarkers; Heart failure; Mitral regurgitation; Transcatheter edge‐to‐edge repair.

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Conflict of interest statement

Declarations. Conflict of interest: Dr. Ravassa reports grants from Instituto de Salud Carlos III, grants from Agencia Estatal de Investigación & Horizon Europe. Dr. Pagnesi has received personal fees from Abbott Vascular, AstraZeneca, Boehringer Ingelheim, Novartis, Novo Nordisk, Roche Diagnostics, and Vifor Pharma. Dr. López reports grants from Instituto de Salud Carlos III, grants from Agencia Estatal de Investigación & Horizon Europe. Dr. San José reports grants from Instituto de Salud Carlos III and grants from Agencia Estatal de Investigación & Horizon Europe. Dr. Metra has received personal fees from Actelion, Amgen, Livanova, and Vifor Pharma as a member of executive or data monitoring committees of sponsored clinical trials and from AstraZeneca, Bayer, Boehringer Ingelheim, Edwards Lifesciences, and Novartis for participation in advisory boards or for speaking at sponsored meetings. Dr. González reports grants from Instituto de Salud Carlos III and grants from Agencia Estatal de Investigación & Horizon Europe. Marianna Adamo received consulting fees in the last 3 years from Abbott Structural Heart and Edwards LifeSciences.

References

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