Baseline characteristics:
175 consecutive patients (61.2% male) with symptomatic (100% NYHA functional class > II), moderate-to-severe or severe MR (PISA: 0.8±0.2 cm, VC: 0.8±1.2 cm, EROA: 0.5±0.3 cm2, RegVol: 51.1±19.7 ml) were included. 40% (n=70) of the patients showed degenerative MR (DMR), 42.8% (n=75) of patients had functional MR (FMR), and 17.2% (n=30) of patients had a mixed etiology. At baseline, all patients were on guideline-directed medical heart-failure therapy or device therapy, if needed. All patients were classified as inoperable or at a high surgical risk by the heart team owing to advanced comorbidities (Logistic EuroScore: 17.8±5.2%), advanced age (mean age: 81.2±8.2 years) and frailty assessed by clinicians’ estimations.
Concerning the baseline demographical and clinical characteristics, there were no statistically significant differences between the groups. Of note, the serum level of NT-proBNP was more elevated in group 2 than group 1, but without reaching the level of statistical significance (4121.9±3955 pg/ml vs 6121.5±8864.7 pg/ml, p=0.1). The baseline demographical and clinical characteristics are presented inTable 1 .
In the overall cohort, baseline echocardiography showed a relevant left-ventricular (LV) dilation (end-diastolic volume [LV-EDV]: 164.7±68.3 ml, end-systolic volume [LV-ESV]: 96.2±58.8 ml) with a decreased LV ejection fraction (LV-EF: 44.7±16.3%). There was no relevant mitral valve stenosis observed at baseline (1.5±1.1 mmHg). Furthermore, we found increased RVSP (45.4±14.8 mmHg) as a sign of pulmonary hypertension at baseline. The baseline echocardiographic parameters were comparable between the groups (Table 2).