title: The Impact of Transcatheter Aortic Valve Implantation on Mitral Regurgitation Regression in High-Risk Patients with Aortic Stenosis.
abstract: OBJECTIVE
  In patients with aortic stenosis, mitral regurgitation (MR) is a common finding. Little is known regarding outcomes of MR in patients undergoing transcatheter aortic valve implantation (TAVI). The study aim was to characterize the short- and mid-term impact of the TAVI procedure on MR grade.
  
  
  METHODS
  A total of 261 patients (59% females; mean age 82.1 +/- 6.9 years) undergoing TAVI was assessed for rates of significant MR and the severity of MR at baseline, and at one month and six months after the procedure.
  
  
  RESULTS
  In patients with moderate MR or above at baseline (n = 26, 10% of the cohort), there was a mean reduction in grade of 1.5 +/- 1.1 and 1.8 +/- 1.4 after one and six months, respectively (p < 0.01). Reduction in MR grade (1+) at six months was identified in 54.1% (40/74) of patients with mild-moderate MR or greater, and in 88.5% (23/26) of those with moderate MR or above, and was associated with an improved NYHA functional class (correlation coefficient r = -0.294, p < 0.001). Multivariate analysis identified low pulmonary pressure and tricuspid regurgitation as independent predictors of improvements in MR.
  
  
  CONCLUSIONS
  Among the present cohort of patients undergoing TAVI, those with MR at baseline showed an improvement in the severity of their MR. Patients with moderate MR regurgitation or above demonstrated the greatest improvement.
authors.forename: Leor
authors.initials: L
authors.lastname: Perl
authors.forename: Mordehay
authors.initials: M
authors.lastname: Vaturi
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.forename: Alexander
authors.initials: A
authors.lastname: Sagie
authors.forename: Adaya
authors.initials: A
authors.lastname: Weissler-Snir
authors.forename: Pablo
authors.initials: P
authors.lastname: Codner
authors.forename: Katia
authors.initials: K
authors.lastname: Orvin
authors.forename: Hana
authors.initials: H
authors.lastname: Vaknin-Assa
authors.forename: Yaron
authors.initials: Y
authors.lastname: Shapira
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D018618:Echocardiography, Doppler, Color; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007557:Israel; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology*; D015999:Multivariate Analysis; D011474:Prosthesis Design; D020127:Recovery of Function; D012042:Registries; D012074:Remission Induction; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome