Mehrdad Rabiee Rad

1 Introduction Ischemic heart disease (IHD) remains a leading global cause of morbidity and mortality, with approximately 315 million prevalent cases and 9.24 million deaths worldwide in 2022 [1]. The burden is particularly substantial in the Eastern Mediterranean Region (EMR), where age-standardized IHD prevalence increased from 5.0% to 5.5% between 1990 and 2019 despite a declining global trend [2].

Conflicts of Interest The authors declare no conflict of interest. Supporting Information Filename Description ccd31555-sup-0001-Supplementary_Material.docx302.2 KB Table S1: Search strategy Table S2: Results of the pooled analysis between patients with pre-TAVR MR ≥ 2 and those with MR < 2. Figure S1-S7: Forest plots for the MD of change-from-baseline EF, LVEDV index, LVESV index, LVEDD, LVESD, AVA, and mean aortic gradient between those with pre-TAVR MR ≥ 2 and patients with pre-TAVR MR < 2.