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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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A Simplified Frailty Measure Improves Risk Stratification in Patients Undergoing Percutaneous Mitral Valve Repair

Clemens Metze1, Elric Zweck2, Christos Iliadis1

  • 1Department of Cardiology, Heart Center Cologne, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany.

Journal of Cachexia, Sarcopenia and Muscle
|December 2, 2025
PubMed
Abstract

Insights

A simplified frailty measure, including exhaustion and slowness, significantly improved risk prediction for mortality and heart failure hospitalization in patients undergoing percutaneous mitral valve repair (PMVR). This frailty assessment should be integrated into clinical decision-making for severe mitral regurgitation.

Area of Science:

  • Cardiology
  • Geriatrics
  • Clinical Risk Prediction

Background:

  • Current risk prediction models for percutaneous mitral valve repair (PMVR) based on organ morbidity have moderate performance.
  • There is a need for improved risk stratification in patients undergoing PMVR.

Purpose of the Study:

  • To examine the utility of frailty measures for risk prediction in patients undergoing PMVR.
  • To assess the additive predictive performance of frailty domains over the existing MitraScore.

Main Methods:

  • Prospective assessment of frailty domains (exhaustion, slowness, inactivity, weakness, weight loss) in patients undergoing PMVR.
  • Examination of the association between frailty domains and mortality/heart failure hospitalization (HFH).
  • Evaluation of a simplified frailty (S-frailty) measure for its predictive performance compared to the MitraScore.

Main Results:

  • Exhaustion, slowness, inactivity, and weakness were significantly associated with increased risk of mortality and HFH.
  • A simplified frailty (S-frailty) measure derived from exhaustion and slowness independently predicted mortality and HFH.
  • Adding S-frailty to the MitraScore significantly improved the prediction of mortality and 1-year mortality risk.

Conclusions:

  • A simplified frailty measure combining exhaustion and gait speed enhances risk prediction in PMVR patients.
  • Frailty assessment should be incorporated into clinical decision-making and risk scores for patients with severe mitral regurgitation.
Keywords:
MitraClipfrailtypercutaneous mitral valve repairrisk score

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