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<p>This study aimed to clarify whether the pulmonary arterial diameter (PAD) to ascending aortic diameter (AoD) ratio on preprocedural computed tomography (CT) provides prognostic information in patients undergoing mitral transcatheter edge-to-edge repair (MTEER). A total of 69 consecutive patients who underwent MTEER between April 2020 and March 2025 were retrospectively analyzed. PAD and AoD were measured on non-contrast CT performed within 3&#xa0;months before the procedure, and patients were classified into higher (≥ 1.0, n = 16) and lower (&lt; 1.0, n = 53) PAD/AoD groups. The primary outcome was a composite of all-cause death and hospitalization for heart failure. During a median follow-up of 555&#xa0;days, the primary outcome occurred in 26 patients. The incidence of the primary outcome was significantly higher in the higher PAD/AoD group (<i>P</i> &lt; 0.001). Multivariable analysis demonstrated that a higher PAD/AoD ratio was an independent predictor of the primary outcome (hazard ratio, 3.86; 95% confidence interval, 1.66–8.95; <i>P</i> = 0.002). These findings suggest that a higher preprocedural PAD/AoD ratio on non-contrast CT was independently associated with adverse clinical outcomes after MTEER, indicating that this CT-derived parameter may serve as a useful marker for risk stratification in these patients.</p>

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Prognostic value of preprocedural pulmonary artery to ascending aorta ratio on non-contrast computed tomography in patients undergoing mitral transcatheter edge-to-edge repair

  • 期刊论文

  • 发表日期：

    2026年1月21日

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  • Hiroki Uehara,
  • Toshiyuki Nagai,
  • So Sasaki,
  • Kento Tamano,
  • Toshifumi Tamura,
  • Akinori Takahashi,
  • Takeshi Hamaya,
  • Yuki Mori,
  • Yutaro Yasui,
  • Sakae Takenaka,
  • Satonori Tsuneta,
  • Suguru Ishizaka,
  • Yuta Kobayashi,
  • Atsushi Tada,
  • Taro Temma,
  • Kiwamu Kamiya,
  • Toshihisa Anzai

摘要

This study aimed to clarify whether the pulmonary arterial diameter (PAD) to ascending aortic diameter (AoD) ratio on preprocedural computed tomography (CT) provides prognostic information in patients undergoing mitral transcatheter edge-to-edge repair (MTEER). A total of 69 consecutive patients who underwent MTEER between April 2020 and March 2025 were retrospectively analyzed. PAD and AoD were measured on non-contrast CT performed within 3 months before the procedure, and patients were classified into higher (≥ 1.0, n = 16) and lower (< 1.0, n = 53) PAD/AoD groups. The primary outcome was a composite of all-cause death and hospitalization for heart failure. During a median follow-up of 555 days, the primary outcome occurred in 26 patients. The incidence of the primary outcome was significantly higher in the higher PAD/AoD group (P < 0.001). Multivariable analysis demonstrated that a higher PAD/AoD ratio was an independent predictor of the primary outcome (hazard ratio, 3.86; 95% confidence interval, 1.66–8.95; P = 0.002). These findings suggest that a higher preprocedural PAD/AoD ratio on non-contrast CT was independently associated with adverse clinical outcomes after MTEER, indicating that this CT-derived parameter may serve as a useful marker for risk stratification in these patients.