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Impact of pulmonary hypertension on outcomes after transcatheter tricuspid valve edge-to-edge repair

Background - Data regarding the association of pulmonary hypertension (PH) and outcomes in patients undergoing transcatheter tricuspid valve edge-to-edge repair (T-TEER) are scarce. - Objectives - The aims of this study were: 1) to investigate the impact of PH on outcomes after T-TEER; and 2) to she...

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Main Authors: Stolz, Lukas (Author) , Kresoja, Karl-Patrik (Author) , von Stein, Jennifer (Author) , Fortmeier, Vera (Author) , Koell, Benedikt (Author) , Rottbauer, Wolfgang (Author) , Kassar, Mohammad (Author) , Goebel, Bjoern (Author) , Denti, Paolo (Author) , Achouh, Paul (Author) , Rassaf, Tienush (Author) , Barreiro-Perez, Manuel (Author) , Boekstegers, Peter (Author) , Rück, Andreas (Author) , Doldi, Philipp M. (Author) , Novotny, Julia (Author) , Zdanyte, Monika (Author) , Adamo, Marianna (Author) , Vincent, Flavien (Author) , Schlegel, Philipp (Author) , von Bardeleben, Ralph Stephan (Author) , Stocker, Thomas J. (Author) , Weckbach, Ludwig T. (Author) , Wild, Mirjam G. (Author) , Besler, Christian (Author) , Brunner, Stephanie (Author) , Toggweiler, Stefan (Author) , Grapsa, Julia (Author) , Patterson, Tiffany (Author) , Thiele, Holger (Author) , Kister, Tobias (Author) , Tarantini, Giuseppe (Author) , Masiero, Giulia (Author) , De Carlo, Marco (Author) , Sticchi, Alessandro (Author) , Konstandin, Mathias H. (Author) , Van Belle, Eric (Author) , Metra, Marco (Author) , Geisler, Tobias (Author) , Estévez-Loureiro, Rodrigo (Author) , Luedike, Peter (Author) , Karam, Nicole (Author) , Maisano, Francesco (Author) , Lauten, Philipp (Author) , Praz, Fabien (Author) , Kessler, Mirjam (Author) , Kalbacher, Daniel (Author) , Rudolph, Volker (Author) , Iliadis, Christos (Author) , Lurz, Philipp (Author) , Hausleiter, Jörg (Author) , Pfister, Roman (Author) , Baldus, Stephan (Author) , Gerçek, Muhammed (Author) , Rudolph, Felix (Author) , Ludwig, Sebastian (Author) , Pauschinger, Christoph (Author) , Schneider, Leonhard-Moritz (Author) , Felbel, Dominik (Author) , Salomon, Carsten (Author) , Lapp, Harald (Author) , Puscas, Tania (Author) , Berrebi, Alain (Author) , Mahabadi, Amir Abbas (Author) , Schindhelm, Florian (Author) , Caneiro-Queija, Berenice (Author) , Echarte-Morales, Julio (Author) , Schreieck, Jürgen (Author) , Goldschmied, Andreas (Author) , Pancaldi, Edoardo (Author) , Tomasoni, Daniela (Author) , Rousse, Natacha (Author) , Aghezzaf, Samy (Author) , Frey, Norbert (Author) , Volz, Martin J. (Author) , Westermann, Dirk (Author) , Rosch, Sebastian (Author) , Arturi, Federico (Author) , Panza, Andrea (Author) , Mazzola, Matteo (Author) , Giannini, Cristina (Author)
Format: Article (Journal)
Language:English
Published: 10 February 2025
In: JACC Cardiovascular interventions
Year: 2025, Volume: 18, Issue: 3, Pages: 325-336
ISSN:1876-7605
DOI:10.1016/j.jcin.2024.10.023
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jcin.2024.10.023
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1936879824014092
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Author Notes:Lukas Stolz, Karl-Patrik Kresoja, Jennifer von Stein, Vera Fortmeier, Benedikt Koell, Wolfgang Rottbauer, Mohammad Kassar, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Manuel Barreiro-Perez, Peter Boekstegers, Andreas Rück, Philipp M. Doldi, Julia Novotny, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Schlegel, Ralph Stephan von Bardeleben, Thomas J. Stocker, Ludwig T. Weckbach, Mirjam G. Wild, Christian Besler, Stephanie Brunner, Stefan Toggweiler, Julia Grapsa, Tiffany Patterson, Holger Thiele, Tobias Kister, Giuseppe Tarantini, Giulia Masiero, Marco De Carlo, Alessandro Sticchi, Mathias H. Konstandin, Eric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Peter Luedike, Nicole Karam, Francesco Maisano, Philipp Lauten, Fabien Praz, Mirjam Kessler, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Philipp Lurz, Jörg Hausleiter, the EuroTR Investigators
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Summary:Background - Data regarding the association of pulmonary hypertension (PH) and outcomes in patients undergoing transcatheter tricuspid valve edge-to-edge repair (T-TEER) are scarce. - Objectives - The aims of this study were: 1) to investigate the impact of PH on outcomes after T-TEER; and 2) to shed further light on the role of precapillary- and postcapillary PH in patients undergoing T-TEER for relevant tricuspid regurgitation (TR). - Methods - The study included patients from EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation; NCT06307262) who underwent T-TEER for relevant TR from 2016 until 2023 with available invasive evaluation of systolic pulmonary artery pressure (sPAP) using right heart catheterization. Study endpoints were procedural TR reduction, improvement in NYHA function class, and a combined endpoint of death or heart failure hospitalization (HFH) at 2 years. - Results - Among a total of 1,230 patients (mean age 78.6 ± 7.0 years, 51.4% women), increasing sPAP was independently associated with increasing rates of 2-year death or HFH (HR: 1.027; 95% CI: 1.003-1.052; P = 0.030; median survival follow-up 343 days [Q1-Q3: 114-645 days]). No significant survival differences were observed for patients with pre- vs postcapillary PH. Sensitivity analysis revealed an sPAP value of 46 mm Hg as the optimized threshold for the prediction of death or HFH. Being observed in 526 patients (42.8%), elevated sPAP (>46 mm Hg) was associated with more severe heart failure symptoms at baseline and follow-up. Importantly, NYHA functional class significantly improved and TR severity was significantly reduced irrespective of PH. - Conclusions - PH is an important outcome predictor in patients undergoing T-TEER for relevant TR. In contrast to previous studies, no significant differences were observed for patients with precapillary and postcapillary PH in terms of survival free from HFH.
Item Description:EuroTR Investigators: Roman Pfister, Martin Kraus [und 28 weitere Personen]
Online veröffentlicht: 28. Oktober 2024, Artikelversion: 10. Februar 2025
Gesehen am 08.12.2025
Physical Description:Online Resource
ISSN:1876-7605
DOI:10.1016/j.jcin.2024.10.023

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