Exercise-Triggered heart valve leak targeted in new trial

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Mild-to-moderate (1+/2+) SMR at rest * Exacerbation of SMR to exercise-induced severe (3+/4+) SMR defined by at least one of the following: * 40 mm\^2 EROA (30 mm\^2 under low-flow condition) or * regurgitant volume ≥60 mL (45 mL under low-flow condition) or * regurgitant fraction ≥40% or * increase by 13 mm\^2 EROA from rest to exercise * Increase in natriuretic peptides defined as NT-proBNP: * \>250 pg/ml (Sinus rhythm) or * \>600 pg/ml (Atrial fibrillation) or * HF hospitalization within 12 months prior to screening (defined as HF listed as the major reason for hospitalization) * NYHA class II-IV * Stable HF medication regimen (GDMT) for at least 30 days prior to index procedure * Patient deemed appropriate candidate for TEER by the local multidisciplinary heart team * Age ≥ 18 years old * Written Informed consent Exclusion Criteria: * Hospitalization in past three months due to myocardial infarction, coronary artery bypass graft surgery, and/or unstable angina * LVEDD \>70 mm * LVEF \<20% * Evidence of transient ischemic attack or stroke within three months prior to intervention * Percutaneous coronary intervention in the last 30 days * Subjects expected to require any cardiac surgery, including surgery for coronary artery disease or for pulmonic, aortic, or tricuspid valve disease within one year * Presence of primary renal dysfunction or significantly compromised renal function (eGFR \<30 ml/min) * Severe right ventricular failure * Severe aortic stenosis (aortic valve area \<1.0 cm\^2) or aortic regurgitation * Hemodynamic instability requiring inotropic support or mechanical heart circulatory support * Presence of a mechanical mitral heart valve, mitral bioprosthetic valve or mitral annuloplasty ring, indication for cardiac resynchronization therapy * Echocardiographic evidence of intracardiac mass, thrombus, or vegetation * Active endocarditis or infections requiring current antibiotic therapy * Hypertrophic cardiomyopathy, restrictive cardiomyopathy, constrictive pericarditis, or any other structural heart disease causing HF other than SMR * Inability to exercise * Pregnancy or planning pregnancy within next12 months * Life expectancy \<12 months (judgement of investigator) * Anticipated need of left ventricular assist device within next 12 months * Participation in another interventional clinical trial (primary endpoint not yet reached) during this trial or within 30 days prior to enrolment into this trial * Previous participation in this trial