Prognostic Impact of Nutritional Status After Transcatheter Edge-to-Edge Mitral Valve Repair: The MIVNUT Registry

Berenice Caneiro-Queija, Sergio Raposeiras-Roubin*, Marianna Adamo, Xavier Freixa, Dabit Arzamendi, Tomas Benito-González, Antonio Montefusco, Isaac Pascual, Luis Nombela-Franco, Josep Rodes-Cabau, Mony Shuvy, Antonio Portolés-Hernández, Cosmo Godino, Dan Haberman, Laura Lupi, Ander Regueiro, Chin Hion Li, Felipe Fernández-Vázquez, Simone Frea, Pablo AvanzasGabriela Tirado-Conte, Jean Michel Paradis, Alona Peretz, Vanessa Moñivas, Jose A. Baz, Michele Galasso, Luca Branca, Laura Sanchís, Lluís Asmarats, Carmen Garrote-Coloma, Filippo Angelini, Victor León, José A. de Agustín, Alberto Alperi, Ronen Beeri, Gloria Maccagni, Manel Sabaté, Estefanía Fernández-Peregrina, Javier Gualis, Pier Paolo Bocchino, Salvatore Curello, Andrés Íñiguez-Romo, Rodrigo Estévez-Loureiro

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


BACKGROUND: Malnutrition is associated with poor prognosis in several cardiovascular diseases. However, its prognostic impact in patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) is not well known. This study sought to assess the prevalence, clinical associations, and prognostic consequences of malnutrition in patients undergoing TEER. METHODS AND RESULTS: A total of 892 patients undergoing TEER from the international MIVNUT (Mitral Valve Repair and Nutritional Status) registry were studied. Malnutrition status was assessed with the Controlling Nutritional Status score. The association of nutritional status with mortality was analyzed with multivariable Cox regression models, whereas the association with heart failure admission was assessed by Fine-Gray models, with death as a competing risk. According to the Controlling Nutritional Status score, 74.4% of patients with TEER had any degree of malnutrition at the time of TEER (75.1% in patients with body mass index <25 kg/m2, 72.1% in those with body mass index ≥25 kg/m2). However, only 20% had moderate–severe malnutrition. TEER was successful in most of patients (94.2%). During a median follow-up of 1.6 years (interquartile range, 0.6–3.0), 267 (29.9%) patients died and 256 patients (28.7%) were admitted for heart failure after TEER. Compared with normal nutritional status moderate–severe malnutrition resulted a strong predictor of mortality (adjusted hazard ratio [HR], 2.1 [95% CI, 1.1–2.4]; P<0.001) and heart failure admission (adjusted subdistribution HR, 1.6 [95% CI, 1.1–2.4]; P=0.015). CONCLUSIONS: Malnutrition is common among patients submitted to TEER, and moderate–severe malnutrition is strongly associated with increased mortality and heart failure readmission. Assessment of nutritional status in these patients may help to improve risk stratification.

Original languageAmerican English
Article numbere023121
JournalJournal of the American Heart Association
Issue number20
StatePublished - 18 Oct 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.


  • heart failure
  • malnutrition
  • mortality
  • transcatheter edge-to-edge repair


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