Supplementary Material for: Impact of Prosthetic Valve Regurgitation Assessed by Echocardiography and Magnetic Resonance Imaging on Long-term Clinical Outcomes after TAVR

Background:
Prosthetic valve regurgitation (PVR) impairs early and mid-term outcomes after transcatheter aortic valve replacement (TAVR). We explored the impact of PVR assessed by transthoracic echocardiography (TTE) and magnetic resonance imaging-regurgitation fraction (MRI-RF) on long-term clinical outcomes.
Methods:
PVR was assessed by TTE applying the Valve Academic Research Consortium criteria and MRI-RF (from velocity-encoded phase contrast magnetic resonance sequence) in 424 patients.
Results:
MRI-RF correlated modestly with the echocardiographic grades of PVR (Spearman's rank correlation coefficient= 0.32, p<0.001). Using an MRI-RF≥20% to define ≥moderate PVR, echocardiography and MRI-RF agreed on PVR classification in 412 patients (97.2%; kappa statistic = 0.56, p<0.001).
Five-year mortality or reintervention was higher in patients with echocardiographic ≥moderate PVR (83.3% vs. 45.0%, log rank p value= 0.002; HR[95% CI]: 3.18[1.48-6.84]) as well as in patients with MRI-RF≥20% (79.3% vs. 43.2%, log rank p value <0.001; HR[95% CI]: 2.68[1.53-4.70])); while the outcomes of patients with echocardiographic mild PVR was not significantly different from those with none-trace PVR. In the two latter groups (echocardiographic