The Houston Methodist CTO-PCI Registry: Contemporary risk profile, procedural characteristics, and outcomes of patients undergoing percutaneous coronary intervention for chronic total occlusion.

Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) remains technically challenging, with ongoing debate about procedural success predictors and long-term outcomes. We report real-world data from the Houston Methodist CTO PCI Registry to characterize procedural success, safety, and mid- to long-term outcomes.

Methods: We retrospectively analyzed 507 patients undergoing CTO PCI between 2018 and 2023.

Staging of Cardiac Adverse Remodeling in Moderate or Severe Aortic Regurgitation.

Background: A recently proposed staging system for cardiac structural and functional abnormalities demonstrated incremental prognostic value in aortic stenosis.

Objectives: The authors investigate a staging system incorporating cardiac magnetic resonance (CMR) in moderate or severe aortic regurgitation (AR).

Methods: Patients prospectively enrolled in DEBAKEY-CMR (DeBakey Cardiovascular Magnetic Resonance Study; NCT04281823) between 2009 and 2020 who had moderate or severe AR by CMR were studied.

Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation.

Tricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. We utilized our large institutional echocardiographic registry, integrated with the electronic medical record-based health system registry to identify patients with varying degrees of TR, and to assess its association with long-term outcomes. Patients were categorized by TR severity as none, mild, moderate, or severe.

Bifid-E Wave: A Novel Doppler Marker of Advanced Mitral Prolapse and Disproportionate Left Ventricular Enlargement.

Background: Mitral valve prolapse (MVP) is a relatively common valvular disease initially assessed using transthoracic echocardiography. We identified a novel mitral inflow Doppler signal-bifid-E wave-in patients with MVP.

Objectives: The authors postulated that the bifid-E wave is predominantly present in bileaflet prolapse (BLP), representing the displaced prolapse volume in early diastole.

Machine Learning Identification of Patient Phenoclusters in Aortic Regurgitation.

Background: Current treatment paradigms assume aortic regurgitation (AR) patients to be a homogenous population, but varied courses of disease progression and outcomes are observed clinically.

Objectives: The aim of this study was to first use unsupervised machine learning to identify unique patient phenoclusters in AR, and subsequently evaluate their prognostic relevance.

Methods: Clinical and cardiac magnetic resonance (CMR) characterization of moderate or severe AR patients was performed across 4 U.

Mitral Transcatheter Edge-to-Edge Repair In-Hospital Outcomes and Mitral Valve Surgery Readmission Trends: National Readmission Database 2018-2020.

•Study design: Utilized the National Readmission Database from 2018-2020. The study included patients over 18 years of age who underwent transcatheter edge-to-edge repair and analyzed readmission for mitral valve (MV) surgery within 180 days.•Readmission rate: Only 1.

Cardiac MRI Evaluation of Determinants and Prognostic Implications of Right Ventricular Dysfunction in Aortic Regurgitation.

Purpose To investigate the determinants and effect of right ventricular (RV) dysfunction in aortic regurgitation (AR) using cardiac MRI. Materials and Methods This study included patients with moderate or severe AR who were enrolled in the DEBAKEY-CMR registry between January 2009 and June 2020. Patients with previous valve intervention, cardiomyopathy deemed unrelated to AR, severe aortic stenosis, and other confounders were excluded.

Meta-Analysis of Dedicated vs Off-Label Transcatheter Devices for Native Aortic Regurgitation.

Background: Transcatheter aortic valve replacement (TAVR) for high surgical risk patients with severe native aortic regurgitation (AR) presents unique challenges. Dedicated devices such as the JenaValve (JenaValve Technology) and J-Valve (JC Medical Inc) show promising results in addressing these challenges.

Objectives: This study compares the safety and efficacy of dedicated vs off-label devices among high surgical risk patients with pure native AR.

Outcomes of mitral transcatheter edge-to-edge repair in patients with mitral annular calcification: A meta-analysis.

Background: The impact of mitral annular calcification (MAC) on the clinical outcomes of patients undergoing mitral transcatheter edge-to-edge repair (MTEER) remains unclear. This meta-analysis aims to evaluate the clinical outcomes of MTEER among patients with moderate to severe MAC compared to those with mild or no MAC.

Methods: We systematically searched PubMed, EMBASE, and Cochrane CENTRAL databases through March 31st, 2024, comparing clinical outcomes of MTEER among patients with moderate/severe (MAC+) versus no/mild MAC (MAC-).

Echocardiographic Evaluation of Chronic Aortic Regurgitation: Comparison With Cardiac Magnetic Resonance and Implications for Guideline Recommendations.

Background: Guidelines for echocardiographic evaluation of aortic regurgitation (AR) have not been validated against an independent quantitative standard.

Objectives: The aim of this study was to evaluate the accuracy of the ASE (American Society of Echocardiography) AR guidelines against cardiac magnetic resonance (CMR) and to develop simplified approaches for detection of significant AR.

Methods: Patients with AR underwent echocardiography and CMR <4 hours apart.

Atrial cardiomyopathy revisited-evolution of a concept: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS).

Aims: The concept of "atrial cardiomyopathy" (AtCM) had been percolating through the literature since its first mention in 1972. Since then, publications using the term were sporadic until the decision was made to convene an expert working group with representation from four multinational arrhythmia organizations to prepare a consensus document on atrial cardiomyopathy in 2016 (EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication). Subsequently, publications on AtCM have increased progressively.

Impact of Left Atrial Pressure on Outcomes After Mitral Transcatheter Edge-to-Edge Repair.

Background: Increased left atrial pressure (LAP) has been associated with adverse outcomes after mitral transcatheter edge-to-edge repair (M-TEER). We sought to evaluate outcomes based on differences in postprocedural LAP measured after the final clip deployment.

Methods: We included consecutive patients who underwent M-TEER at our institution between 2014 and 2022 with LAP monitoring.

Prognostic Value of Right Ventricular Afterload in Patients Undergoing Mitral Transcatheter Edge-to-Edge Repair.

Background: Pulmonary hypertension (PH) and secondary mitral regurgitation (MR) are associated with adverse outcomes after mitral transcatheter edge-to-edge repair. We aim to study the prognostic value of invasively measured right ventricular afterload in patients undergoing mitral transcatheter edge-to-edge repair.

Methods And Results: We identified patients who underwent right heart catheterization ≤1 month before transcatheter edge-to-edge repair.

Echocardiographic Profiling Predicts Clinical Outcomes After Mitral Transcatheter Edge-to-Edge Repair.

Background: Prior studies investigating the impact of residual mitral regurgitation (MR), tricuspid regurgitation (TR), and elevated predischarge transmitral mean pressure gradient (TMPG) on outcomes after mitral transcatheter edge-to-edge repair (TEER) have assessed each parameter in isolation. We sought to examine the prognostic value of combining predischarge MR, TR, and TMPG to study long-term outcomes after TEER.

Methods And Results: We reviewed the records of 291 patients who underwent successful mitral TEER at our institution between March 2014 and June 2022.

Noninvasive Prediction of Pulmonary Capillary Wedge Pressure in Patients With Normal Left Ventricular Ejection Fraction: Comparison of Cardiac Magnetic Resonance With Comprehensive Echocardiography.

Background: Cardiac magnetic resonance (CMR) was recently reported to predict mean pulmonary capillary wedge pressure (PCWP). However, there is a paucity of data on its accuracy for estimation of PCWP in patients with normal left ventricular (LV) ejection fraction (EF). We sought to examine its accuracy against the invasive gold standard and to compare it with the accuracy of comprehensive echocardiography.

Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging: A Report From the American Society of Echocardiography Developed in Collaboration With the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography.

In patients with significant cardiac valvular disease, intervention with either valve repair or valve replacement may be inevitable. Although valve repair is frequently performed, especially for mitral and tricuspid regurgitation, valve replacement remains common, particularly in adults. Diagnostic methods are often needed to assess the function of the prosthesis.