TY - JOUR
T1 - Value of Echocardiographic Right Ventricular and Pulmonary Pressure Assessment in Predicting Transcatheter Tricuspid Repair Outcome
AU - Karam, Nicole
AU - Mehr, Michael
AU - Taramasso, Maurizio
AU - Besler, Christian
AU - Ruf, Tobias
AU - Connelly, Kim A.
AU - Weber, Marcel
AU - Yzeiraj, Ermela
AU - Schiavi, Davide
AU - Mangieri, Antonio
AU - Vaskelyte, Laura
AU - Alessandrini, Hannes
AU - Deuschl, Florian
AU - Brugger, Nicolas
AU - Ahmad, Hasan
AU - Ho, Edwin
AU - Biasco, Luigi
AU - Orban, Mathias
AU - Deseive, Simon
AU - Braun, Daniel
AU - Gavazzoni, Mara
AU - Rommel, Karl Philipp
AU - Pozzoli, Alberto
AU - Frerker, Christian
AU - Näbauer, Michael
AU - Massberg, Steffen
AU - Pedrazzini, Giovanni
AU - Tang, Gilbert H.L.
AU - Windecker, Stephan
AU - Schäfer, Ulrich
AU - Kuck, Karl Heinz
AU - Sievert, Horst
AU - Denti, Paolo
AU - Latib, Azeem
AU - Schofer, Joachim
AU - Nickenig, Georg
AU - Fam, Neil
AU - von Bardeleben, Stephan
AU - Lurz, Philipp
AU - Maisano, Francesco
AU - Hausleiter, Jörg
N1 - Funding Information:
Dr. Karam has received consulting fees from Abbott Vascular. Dr. Mehr has received travel grants from Bristol-Myers Squibb. Dr. Connelly has received honoraria from Abbott; and is supported by a new investigator award from Canadian Institutes of Health Research and an early researcher award from the Ministry of Health. Dr. Braun has received speaking honoraria from Abbott Vascular. Dr. Nabauer has received speaking honoraria from Abbott Vascular. Dr. Tang is a consultant for Abbott Structural Heart. Dr. Windecker has received research contracts to the institution from Abbott, Amgen, Bayer, Boston Scientific, Biotronik, Medtronic, Edwards Lifesciences, St. Jude Medical, and Terumo. Dr. Schäfer has received consulting, grant support, travel, and speaking honoraria from Abbott. Dr. Latib has received consulting fees from Medtronic, Abbott, and Edwards Lifesciences. Dr. Hausleiter has received research support and speaking honoraria from Abbott Vascular and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Funding Information:
Dr. Karam has received consulting fees from Abbott Vascular. Dr. Mehr has received travel grants from Bristol-Myers Squibb. Dr. Connelly has received honoraria from Abbott; and is supported by a new investigator award from Canadian Institutes of Health Research and an early researcher award from the Ministry of Health. Dr. Braun has received speaking honoraria from Abbott Vascular. Dr. Nabauer has received speaking honoraria from Abbott Vascular. Dr. Tang is a consultant for Abbott Structural Heart. Dr. Windecker has received research contracts to the institution from Abbott, Amgen, Bayer, Boston Scientific, Biotronik, Medtronic, Edwards Lifesciences, St. Jude Medical, and Terumo. Dr. Schäfer has received consulting, grant support, travel, and speaking honoraria from Abbott. Dr. Latib has received consulting fees from Medtronic, Abbott, and Edwards Lifesciences. Dr. Hausleiter has received research support and speaking honoraria from Abbott Vascular and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2020 American College of Cardiology Foundation
PY - 2020/5/25
Y1 - 2020/5/25
N2 - Objectives: The aim of this study was to assess the value of echocardiographic right ventricular (RV) and systolic pulmonary artery pressure (sPAP) assessment in predicting transcatheter tricuspid edge-to-edge valve repair (TTVR) outcome. Background: RV dysfunction and pulmonary hypertension are associated with poor prognosis and are systematically sought during tricuspid regurgitation evaluation. The value of echocardiographic assessment in predicting TTVR outcome is unknown. Methods: Data were taken from the TriValve (Transcatheter Tricuspid Valve Therapies) registry, which includes patients undergoing TTVR at 14 European and North American centers. The primary outcome was 1-year survival free from hospitalization for heart failure, and secondary outcomes were 1-year survival and absence of hospital admission for heart failure at 1 year. Results: Overall, 249 patients underwent TTVR between June 2015 and 2018 (mean tricuspid annular plane systolic excursion [TAPSE] 15.8 ± 15.3 mm, mean sPAP 43.6 ± 16.0 mm Hg). Tricuspid regurgitation grade ≥3+ was found in 96.8% of patients at baseline and 29.4% at final follow-up; 95.6% were in New York Heart Association functional class III or IV initially, compared with 34.3% at follow-up (p < 0.05). Final New York Heart Association functional class did not differ among TAPSE and sPAP quartiles, even when both low TAPSE and high sPAP were present. Rates of 1-year survival and survival free from hospitalization for heart failure were 83.9% and 78.7%, respectively, without significant differences according to baseline echocardiographic RV characteristics (TAPSE, fractional area change, and end-diastolic area) and sPAP (p > 0.05 for all). Conclusions: TTVR provides clinical improvement, with 1-year survival free from hospital readmission >75% in patients with severe tricuspid regurgitation. Conventional echocardiographic parameters used to assess RV function and sPAP did not predict clinical outcome after TTVR.
AB - Objectives: The aim of this study was to assess the value of echocardiographic right ventricular (RV) and systolic pulmonary artery pressure (sPAP) assessment in predicting transcatheter tricuspid edge-to-edge valve repair (TTVR) outcome. Background: RV dysfunction and pulmonary hypertension are associated with poor prognosis and are systematically sought during tricuspid regurgitation evaluation. The value of echocardiographic assessment in predicting TTVR outcome is unknown. Methods: Data were taken from the TriValve (Transcatheter Tricuspid Valve Therapies) registry, which includes patients undergoing TTVR at 14 European and North American centers. The primary outcome was 1-year survival free from hospitalization for heart failure, and secondary outcomes were 1-year survival and absence of hospital admission for heart failure at 1 year. Results: Overall, 249 patients underwent TTVR between June 2015 and 2018 (mean tricuspid annular plane systolic excursion [TAPSE] 15.8 ± 15.3 mm, mean sPAP 43.6 ± 16.0 mm Hg). Tricuspid regurgitation grade ≥3+ was found in 96.8% of patients at baseline and 29.4% at final follow-up; 95.6% were in New York Heart Association functional class III or IV initially, compared with 34.3% at follow-up (p < 0.05). Final New York Heart Association functional class did not differ among TAPSE and sPAP quartiles, even when both low TAPSE and high sPAP were present. Rates of 1-year survival and survival free from hospitalization for heart failure were 83.9% and 78.7%, respectively, without significant differences according to baseline echocardiographic RV characteristics (TAPSE, fractional area change, and end-diastolic area) and sPAP (p > 0.05 for all). Conclusions: TTVR provides clinical improvement, with 1-year survival free from hospital readmission >75% in patients with severe tricuspid regurgitation. Conventional echocardiographic parameters used to assess RV function and sPAP did not predict clinical outcome after TTVR.
KW - edge-to-edge repair
KW - outcome
KW - pulmonary artery pressure
KW - right ventricular function
KW - tricuspid regurgitation
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U2 - 10.1016/j.jcin.2020.02.028
DO - 10.1016/j.jcin.2020.02.028
M3 - Article
C2 - 32360260
AN - SCOPUS:85084359370
SN - 1936-8798
VL - 13
SP - 1251
EP - 1261
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 10
ER -