TY - JOUR
T1 - Prognostic impact of being underweight in patients undergoing mitral TEER
T2 - The OCEAN-Mitral registry
AU - the OCEAN-Mitral Investigators
AU - Higuchi, Ryosuke
AU - Izumo, Masaki
AU - Izumi, Yuki
AU - Saji, Mike
AU - Isobe, Mitsuaki
AU - Akashi, Yoshihiro
AU - Yamamoto, Masanori
AU - Asami, Masahiko
AU - Enta, Yusuke
AU - Nakashima, Masaki
AU - Shirai, Shinichi
AU - Mizuno, Shingo
AU - Watanabe, Yusuke
AU - Amaki, Makoto
AU - Kodama, Kazuhisa
AU - Yamaguchi, Junichi
AU - Naganuma, Toru
AU - Bota, Hiroki
AU - Ohno, Yohei
AU - Yamawaki, Masahiro
AU - Ueno, Hiroshi
AU - Mizutani, Kazuki
AU - Kubo, Shunsuke
AU - Otsuka, Toshiaki
AU - Hayashida, Kentaro
N1 - Publisher Copyright:
© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2025/2
Y1 - 2025/2
N2 - Aims: Mitral transcatheter edge-to-edge repair (M-TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M-TEER candidates for effective patient selection, optimal periprocedural care and improved long-term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported. Methods and Results: Between April 2018 and June 2021, 2149 patients undergoing M-TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25 kg/m2) and overweight and obese (25 kg/m2 ≦ BMI) [Correction added on 17 October 2024, after first online publication: In the preceding sentence, “18.5 ☆ BMI < 25 kg/m2” and “25 kg/m2 ☆ BMI” have been corrected to “18.5 ≤ BMI < 25 kg/m2” and “25 kg/m2 ≦ BMI” in this version.] The impact of underweight on the all-cause, cardiovascular and non-cardiovascular mortality following M-TEER was evaluated [follow-up duration: 436 (363–733) days]. The participants (median BMI: 21.1 kg/m2) were categorized as underweight (n = 450, 20.9%), normal weight (n = 1409, 65.6%) and overweight and obese (n = 290, 13.5%). Compared with the other two groups, the underweight group exhibited several negative prognostic factors, including older age, frailty, no dyslipidaemia, hypoalbuminaemia, residual MR and non-home discharge. Underweight patients had the highest rate of all-cause, cardiovascular and non-cardiovascular mortality, whereas those in the other two groups were similar. As per the multivariate analysis, underweight itself was associated with all-cause mortality (hazard ratio: 1.52, 95% confidence interval: 1.17–1.97, P = 0.009) and cardiovascular mortality (hazard ratio: 1.45, 95% confidence interval: 1.04–2.01, P = 0.028). Conclusions: Underweight patients had the highest mortality rate after M-TEER. Comorbidities, residual MR, discharge disposition and underweight status were correlated with postprocedural outcome.
AB - Aims: Mitral transcatheter edge-to-edge repair (M-TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M-TEER candidates for effective patient selection, optimal periprocedural care and improved long-term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported. Methods and Results: Between April 2018 and June 2021, 2149 patients undergoing M-TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25 kg/m2) and overweight and obese (25 kg/m2 ≦ BMI) [Correction added on 17 October 2024, after first online publication: In the preceding sentence, “18.5 ☆ BMI < 25 kg/m2” and “25 kg/m2 ☆ BMI” have been corrected to “18.5 ≤ BMI < 25 kg/m2” and “25 kg/m2 ≦ BMI” in this version.] The impact of underweight on the all-cause, cardiovascular and non-cardiovascular mortality following M-TEER was evaluated [follow-up duration: 436 (363–733) days]. The participants (median BMI: 21.1 kg/m2) were categorized as underweight (n = 450, 20.9%), normal weight (n = 1409, 65.6%) and overweight and obese (n = 290, 13.5%). Compared with the other two groups, the underweight group exhibited several negative prognostic factors, including older age, frailty, no dyslipidaemia, hypoalbuminaemia, residual MR and non-home discharge. Underweight patients had the highest rate of all-cause, cardiovascular and non-cardiovascular mortality, whereas those in the other two groups were similar. As per the multivariate analysis, underweight itself was associated with all-cause mortality (hazard ratio: 1.52, 95% confidence interval: 1.17–1.97, P = 0.009) and cardiovascular mortality (hazard ratio: 1.45, 95% confidence interval: 1.04–2.01, P = 0.028). Conclusions: Underweight patients had the highest mortality rate after M-TEER. Comorbidities, residual MR, discharge disposition and underweight status were correlated with postprocedural outcome.
KW - body mass index
KW - obesity paradox
KW - outcome
KW - transcatheter edge-to-edge repair
KW - underweight
UR - http://www.scopus.com/inward/record.url?scp=85204503083&partnerID=8YFLogxK
U2 - 10.1002/ehf2.15047
DO - 10.1002/ehf2.15047
M3 - 学術論文
C2 - 39308333
AN - SCOPUS:85204503083
SN - 2055-5822
VL - 12
SP - 408
EP - 417
JO - ESC Heart Failure
JF - ESC Heart Failure
IS - 1
ER -
