Osteresch R, Diehl K, Schmucker J, et al. - Researchers analyzed patients with severe functional mitral regurgitation (MR) and chronic heart failure (CHF) receiving transcatheter mitral valve repair (TMVR), to determine the prognostic effect of pulmonary artery (PA) pulsatility index (PAPi), calculated as (PA systolic pressure – PA diastolic pressure)/right atrial pressure, in these patients. This study involved 78 patients at high operative risk. The participants were split into 3 categories based on PAPi (A: low PAPi ≤ 2.2; B: intermediate PAPi 2.21–3.99; C: high PAPi ≥ 4.0). A mean follow-up of 16 ± 4 months was performed, during which, a composite of all-cause death and rehospitalization due to CHF was assessed (primary endpoint). Findings showed a strong link of PAPi with clinical outcome in patients with CHF and functional MR receiving TMVR. A worse prognosis was predicted by a PAPi value ≤ 2.46 independent of other essential clinical, echocardiographic, and hemodynamic factors. Thus, PAPi was concluded to be a likely new parameter to improve patient selection for TMVR.