A Composite Index for Predicting Mitral Regurgitation Improvement in Patients with Multivalvular Heart Disease After Transcatheter Aortic Valve Replacement

Zhi-cheng Xiao¹Guibin Zheng²Tian-xiang Geng²Zhong-Fei Lu³Zhen Wang¹Lei Zheng²Fa-xin Ren^1*

• ¹Department of Cardiology, Yantai Yuhuangding Hospital, Yantai, China
• ²Yantai Yuhuangding Hospital, Yantai, China
• ³Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Beijing, China

Transcatheter aortic valve replacement (TAVR) has emerged as a standard therapy for severe aortic stenosis (AS), withwhere concomitant mitral regurgitation (MR) is observed in 19%–29% of cases. While MR frequentlycy improves post-TAVR, persistent MR is associated with worse outcomes, highlighting the need for effectivebetter predictive tools. This single-center retrospective study evaluated 53 patients with severe AS and moderate/severe MR undergoing TAVR between 2017 and 2024. MR improvement (defined as ≥1 grade reduction) occurred in 67.9% of patients atwithin one year. Multivariable logistic regression identified the presence of persistent atrial fibrillation (AF) (OR: 0.017-0.575 0.015–0.516, P = 0.01) and eccentric MR (OR: 0.012-0.3700.017– 0.408, P = 0.002) as independent negative predictors, while greater interventricular septal thickness (OR: 1.075-3.099 0.460–32.612, P = 0.026) emerged as a positive predictor. The composite index incorporating these factors demonstrated excellent discriminative capacity, [with an area under the curve (AUC) of= 0.909], offering a novel approach to optimize patient selection for TAVR.