TY - JOUR
T1 - Prognostic Value of Tricuspid Valve Gradient After Transcatheter Edge-to-Edge Repair
T2 - Insights From the TriValve Registry
AU - Coisne, Augustin
AU - Scotti, Andrea
AU - Taramasso, Maurizio
AU - Granada, Juan F.
AU - Ludwig, Sebastian
AU - Rodés-Cabau, Josep
AU - Lurz, Philipp
AU - Hausleiter, Jörg
AU - Fam, Neil
AU - Kodali, Susheel K.
AU - Pozzoli, Alberto
AU - Alessandrini, Hannes
AU - Biasco, Luigi
AU - Brochet, Eric
AU - Denti, Paolo
AU - Estevez-Loureiro, Rodrigo
AU - Frerker, Christian
AU - Ho, Edwin C.
AU - Monivas, Vanessa
AU - Nickenig, Georg
AU - Praz, Fabien
AU - Puri, Rishi
AU - Sievert, Horst
AU - Tang, Gilbert H.L.
AU - Andreas, Martin
AU - Von Bardeleben, Ralph Stephan
AU - Rommel, Karl Philipp
AU - Muntané-Carol, Guillem
AU - Gavazzoni, Mara
AU - Braun, Daniel
AU - Lubos, Edith
AU - Kalbacher, Daniel
AU - Connelly, Kim A.
AU - Juliard, Jean Michel
AU - Harr, Claudia
AU - Pedrazzini, Giovanni
AU - Philippon, François
AU - Schofer, Joachim
AU - Thiele, Holger
AU - Unterhuber, Matthias
AU - Himbert, Dominique
AU - Alcázar, Marina Ureña
AU - Wild, Mirjam G.
AU - Jorde, Ulrich
AU - Windecker, Stephan
AU - Maisano, Francesco
AU - Leon, Martin B.
AU - Hahn, Rebecca T.
AU - Latib, Azeem
N1 - Publisher Copyright:
© 2023
PY - 2023/3/27
Y1 - 2023/3/27
N2 - Background: Data regarding the impact of the tricuspid valve gradient (TVG) after tricuspid transcatheter edge-to-edge repair (TEER) are scarce. Objectives: This study sought to evaluate the association between the mean TVG and clinical outcomes among patients who underwent tricuspid TEER for significant tricuspid regurgitation. Methods: Patients with significant tricuspid regurgitation who underwent tricuspid TEER within the TriValve (International Multisite Transcatheter Tricuspid Valve Therapies) registry were divided into quartiles based on the mean TVG at discharge. The primary endpoint was the composite of all-cause mortality and heart failure hospitalization. Outcomes were assessed up to the 1-year follow-up. Results: A total of 308 patients were included from 24 centers. Patients were divided into quartiles of the mean TVG as follows: quartile 1 (n = 77), 0.9 ± 0.3 mm Hg; quartile 2 (n = 115), 1.8 ± 0.3 mm Hg; quartile 3 (n = 65), 2.8 ± 0.3 mm Hg; and quartile 4 (n = 51), 4.7 ± 2.0 mm Hg. The baseline TVG and the number of implanted clips were associated with a higher post-TEER TVG. There was no significant difference across TVG quartiles in the 1-year composite endpoint (quartiles 1-4: 35%, 30%, 40%, and 34%, respectively; P = 0.60) or the proportion of patients in New York Heart Association class III to IV at the last follow-up (P = 0.63). The results were similar after adjustment for clinical and echocardiographic characteristics (composite endpoint quartile 4 vs quartile 1-quartile 3 adjusted HR: 1.05; 95% CI: 0.52-2.12; P = 0.88) or exploring post-TEER TVG as a continuous variable. Conclusions: In this retrospective analysis of the TriValve registry, an increased discharge TVG was not significantly associated with adverse outcomes after tricuspid TEER. These findings apply for the explored TVG range and up to the 1-year follow-up. Further investigations on higher gradients and longer follow-up are needed to better guide the intraprocedural decision-making process.
AB - Background: Data regarding the impact of the tricuspid valve gradient (TVG) after tricuspid transcatheter edge-to-edge repair (TEER) are scarce. Objectives: This study sought to evaluate the association between the mean TVG and clinical outcomes among patients who underwent tricuspid TEER for significant tricuspid regurgitation. Methods: Patients with significant tricuspid regurgitation who underwent tricuspid TEER within the TriValve (International Multisite Transcatheter Tricuspid Valve Therapies) registry were divided into quartiles based on the mean TVG at discharge. The primary endpoint was the composite of all-cause mortality and heart failure hospitalization. Outcomes were assessed up to the 1-year follow-up. Results: A total of 308 patients were included from 24 centers. Patients were divided into quartiles of the mean TVG as follows: quartile 1 (n = 77), 0.9 ± 0.3 mm Hg; quartile 2 (n = 115), 1.8 ± 0.3 mm Hg; quartile 3 (n = 65), 2.8 ± 0.3 mm Hg; and quartile 4 (n = 51), 4.7 ± 2.0 mm Hg. The baseline TVG and the number of implanted clips were associated with a higher post-TEER TVG. There was no significant difference across TVG quartiles in the 1-year composite endpoint (quartiles 1-4: 35%, 30%, 40%, and 34%, respectively; P = 0.60) or the proportion of patients in New York Heart Association class III to IV at the last follow-up (P = 0.63). The results were similar after adjustment for clinical and echocardiographic characteristics (composite endpoint quartile 4 vs quartile 1-quartile 3 adjusted HR: 1.05; 95% CI: 0.52-2.12; P = 0.88) or exploring post-TEER TVG as a continuous variable. Conclusions: In this retrospective analysis of the TriValve registry, an increased discharge TVG was not significantly associated with adverse outcomes after tricuspid TEER. These findings apply for the explored TVG range and up to the 1-year follow-up. Further investigations on higher gradients and longer follow-up are needed to better guide the intraprocedural decision-making process.
KW - transcatheter edge-to-edge repair
KW - transcatheter tricuspid valve intervention
KW - tricuspid regurgitation
KW - tricuspid valve gradient
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U2 - 10.1016/j.jcin.2023.01.375
DO - 10.1016/j.jcin.2023.01.375
M3 - Article
C2 - 36948892
AN - SCOPUS:85150389276
SN - 1936-8798
VL - 16
SP - 706
EP - 717
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 6
ER -