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In patients with heart failure (HF) and secondary mitral regurgitation (SMR) undergoing transcatheter edge-to-edge repair (TEER) the role of guideline directed medical therapy (GDMT) after the procedure has been unclear. In a retrospective analysis of 463 patients undergoing TEER for SMR, Tanaka and colleagues1 observed a lower 2 year mortality in the 228 (49%) treated with GDMT, defined as triple therapy consisting of beta-blockers, renin–angiotensin system inhibitors and mineralocorticoid receptor antagonists, compared with those who did not receive GDMT (HR: 0.58; 95% CI: 0.35 to 0.95; p=0.030) (figure 1). Reverse left ventricular remodelling (a reduction in the LV end-systolic volume of ≥10% from baseline to 1 year follow-up) also was more common in patients on GDMT (40.2% vs 26.8%; p=0.038).
In the accompanying editorial, Alharethi and colleagues2 point out that these ‘findings reinforce the importance of engaging focused heart failure (HF) cardiologists and allied teams to optimise medical therapy before and after TEER’. A team approach is even more relevant now given the additional benefits of SGLT2 inhibitors for HF, which were not recommended at the time of the current study.
Also in this issue of Heart, the clinical features and outcomes of recurrent infective endocarditis (IE) are reported from the EUROpean ENDOcarditis (EURO-ENDO) registry, which includes 156 centres and …
Footnotes
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.