Electrical Risk Score predicts 6-month heart failure readmission after transcatheter edge-to-edge repair: a single-center retrospective cohort study

Objectives Transcatheter Edge-to-Edge Repair (TEER) is a minimally invasive cardiac interventional procedure designed to cure a most common valvular heart disease——mitral regurgitation. Electrical risk score (ERS), as a simple and convenient test, uses the interpretation of a standard 12-lead electrocardiogram (ECG). We explore that ERS Provides clues about the prognosis of patients undergoing transcatheter edge-to-edge mitral valve repair (TEER). Methods In this retrospective study, a total of 106 patients who underwent TEER were enrolled. ERS was calculated based on six electrocardiographic parameters: heart rate > 75 bpm, left ventricular hypertrophy, delayed QRS transition zone, frontal QRS–T angle > 90°, prolonged QTc interval, and prolonged Tpeak–Tend interval. Patients were categorized into a low‑risk group (ERS < 4) and a high‑risk group (ERS ≥ 4). The primary endpoint was HF rehospitalization within 6 months after the procedure. Results Twelve patients were assigned to the high‑ERS group, and the remaining 94 patients constituted the low‑ERS group. Compared with the low‑ERS group, the high‑ERS group had a significantly higher rate of HF rehospitalization (P < 0.001), along with higher BNP levels and worse renal function. We also compared ECG parameters between patients with and without HF rehospitalization; the mean ERS was significantly higher in the rehospitalization group than in the non‑rehospitalization group (3.44 ± 0.73 vs. 1.99 ± 0.73, P < 0.05). ROC analysis demonstrated that ERS had excellent predictive ability for HF rehospitalization (AUC = 0.856), outperforming any single ECG parameter. Multivariable logistic regression analysis further showed that ERS (OR = 2.74, 95% CI: 1.44–5.34, P = 0.005) and NYHA class were independent predictors of HF rehospitalization. Conclusions Through our research, it seems that ERS can be a feasible tool to stratify the risk of relapse in half-year follow-up of TEER patients. However, larger scale experiments are yet to be conducted to support our research findings.