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Tricuspid regurgitation disease stages and treatment outcomes after transcatheter tricuspid valve repair

Background - Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a treatment option for patients with severe tricuspid regurgitation (TR). However, randomized trials have not shown a survival benefit, possibly because of the inclusion of patients in an early or too advanced disease s...

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Main Authors: Schlotter, Florian (Author) , Stolz, Lukas (Author) , Kresoja, Karl-Patrik (Author) , von Stein, Jennifer (Author) , Fortmeier, Vera (Author) , Koell, Benedikt (Author) , Rottbauer, Wolfgang (Author) , Kassar, Mohammad (Author) , Schöber, Anne (Author) , Goebel, Bjoern (Author) , Denti, Paolo (Author) , Achouh, Paul (Author) , Rassaf, Tienush (Author) , Rück, Andreas (Author) , Zdanyte, Monika (Author) , Adamo, Marianna (Author) , Vincent, Flavien (Author) , Schlegel, Philipp (Author) , von Bardeleben, Ralph Stephan (Author) , Wild, Mirjam G. (Author) , Toggweiler, Stefan (Author) , Konstandin, Mathias (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) , Heitkemper, Megan (Author) , Peterman, Kelli (Author) , Bekeredjian, Raffi (Author) , Schmitz, Thomas (Author) , Nickenig, Georg (Author) , Donal, Erwan (Author) , Kister, Tobias (Author) , Thiele, Holger (Author) , Rommel, Karl-Philipp (Author) , Kalbacher, Daniel (Author) , Rudolph, Volker (Author) , Iliadis, Christos (Author) , Lauten, Alexander (Author) , Hausleiter, Jörg (Author) , Lurz, Philipp (Author) , Doldi, Philipp M. (Author) , Schreieck, Jürgen (Author) , Weckbach, Ludwig T. (Author) , Goldschmied, Andreas (Author) , Rosch, Sebastian (Author) , Pancaldi, Edoardo (Author) , Pfister, Roman (Author) , Tomasoni, Daniela (Author) , Baldus, Stephan (Author) , Rousse, Natacha (Author) , Gerçek, Muhammed (Author) , Aghezzaf, Samy (Author) , Rudolph, Felix (Author) , Frey, Norbert (Author) , Ludwig, Sebastian (Author) , Raake, Philip (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, Julio C. (Author)
Format: Article (Journal)
Language:English
Published: 10 February 2025
In: JACC Cardiovascular interventions
Year: 2025, Volume: 18, Issue: 3, Pages: 339-348
ISSN:1876-7605
DOI:10.1016/j.jcin.2024.10.034
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jcin.2024.10.034
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1936879824014705
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Author Notes:Florian Schlotter, Lukas Stolz, Karl-Patrik Kresoja, Jennifer von Stein, Vera Fortmeier, Benedikt Koell, Wolfgang Rottbauer, Mohammad Kassar, Anne Schöber, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Andreas Rück, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Schlegel, Ralph Stephan von Bardeleben, Mirjam G. Wild, Stefan Toggweiler, 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, Megan Heitkemper, Kelli Peterman, Raffi Bekeredjian, Thomas Schmitz, Georg Nickenig, Erwan Donal, Tobias Kister, Holger Thiele, Karl-Philipp Rommel, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Alexander Lauten, Jörg Hausleiter, Philipp Lurz, the EuroTR Investigators
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Summary:Background - Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a treatment option for patients with severe tricuspid regurgitation (TR). However, randomized trials have not shown a survival benefit, possibly because of the inclusion of patients in an early or too advanced disease stage. - Objectives - The authors sought to investigate the association between disease stage and outcomes following T-TEER. - Methods - In total, 1,885 patients with significant TR were analyzed, including 585 conservatively treated individuals and 1,300 patients who received T-TEER. Patients were evaluated as part of the prospective EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation) registry and grouped into early, intermediate, and advanced disease stage. Disease stage was based on left and right ventricular function, renal function, and natriuretic peptide levels. The stratification was validated in an external cohort. The primary endpoint was 1-year mortality. - Results - Overall, 395 patients (21% [395/1,885]) were categorized as early, 1,173 patients (62% [1,173/1,885]) as intermediate, and 317 patients (17% [317/1,885]) as advanced disease stage. In patients with early and advanced disease, mortality did not differ between interventional and conservative treatment (early-stage HR: 0.78; 95% CI: 0.34-1.80; P = 0.54; advanced stage HR: 1.06; 95% CI: 0.71-1.60; P = 0.78). However, mortality was significantly lower in patients undergoing percutaneous treatment with intermediate disease stage (HR: 0.73; 95% CI: 0.52-0.99; P = 0.03). - Conclusions - Compared to medically treated controls, T-TEER was associated with 1-year survival at intermediate stage disease but not at early or advanced disease stages. The timing of T-TEER with regard to disease stages might be crucial to optimize treatment benefits.
Item Description:Online veröffentlicht: 10. Februar 2025
EuroTR Investigators: Philipp M. Doldi, Jürgen Schreieck, Ludwig T. Weckbach, Andreas Goldschmied, Sebastian Rosch, Edoardo Pancaldi, Roman Pfister, Daniela Tomasoni, Stephan Baldus, Natacha Rousse, Muhammed Gerçek, Samy Aghezzaf, Felix Rudolph, Norbert Frey, Sebastian Ludwig, Philip Raake, Christoph Pauschinger, Leonhard-Moritz Schneider, Dominik Felbel, Carsten Salomon, Harald Lapp, Tania Puscas, Alain Berrebi, Amir Abbas Mahabadi, Florian Schindhelm, Berenice Caneiro-Queija, Julio C. Echarte
Gesehen am 09.12.2025
Physical Description:Online Resource
ISSN:1876-7605
DOI:10.1016/j.jcin.2024.10.034

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