The relevance of right ventricular function and dimension in patients undergoing transcatheter tricuspid edge-to-edge repair
Background - Patients with severe tricuspid regurgitation (TR) often present with abnormal right ventricular (RV) function and dimensions. - Objectives - The aim of this study was to investigate the impact of RV dysfunction and dilation on clinical outcomes in patients undergoing transcatheter tricu...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2025 July 28
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| In: |
JACC Cardiovascular interventions
Year: 2025, Volume: 18, Issue: 14, Pages: 1737-1745 |
| ISSN: | 1876-7605 |
| DOI: | 10.1016/j.jcin.2025.05.037 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jcin.2025.05.037 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1936879825016358 
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| Author Notes: | Stephanie Brunner, MD, Lukas Stolz, MD, Karl-Patrik Kresoja, MD, Jennifer von Stein, MD, Vera Fortmeier, MD, Benedikt Koell, MD, Wolfgang Rottbauer, MD, Mohammad Kassar, MD, Bjoern Goebel, MD, Paolo Denti, MD, Paul Achouh, MD, Tienush Rassaf, MD, Manuel Barreiro-Perez, MD, Peter Boekstegers, MD, Andreas Rück, MD, Monika Zdanyte, MD, Flavien Vincent, MD, PhD, Philipp Schlegel, MD, Ralph Stephan von Bardeleben, MD, Mirjam G. Wild, MD, Christian Besler, MD, Matteo Pagnesi, MD, PhD, Marianna Adamo, MD, PhD, Julia Grapsa, MD, Tiffany Patterson, MD, Holger Thiele, MD, Tobias Kister, MD, Giuseppe Tarantini, MD, PhD, Giulia Masiero, MD, Marco De Carlo, MD, Alessandro Sticchi, MD, Mathias H. Konstandin, MD, Eric Van Belle, MD, PhD, Tobias Geisler, MD, Rodrigo Estévez-Loureiro, MD, Peter Luedike, MD, Nicole Karam, MD, Francesco Maisano, MD, Philipp Lauten, MD, Fabien Praz, MD, Mirjam Kessler, MD, Daniel Kalbacher, MD, Volker Rudolph, MD, Christos Iliadis, MD, Philipp Lurz, MD, Marco Metra, MD, Jörg Hausleiter, MD, Stefan Toggweiler, MD, the EuroTR Investigators |
| Summary: | Background - Patients with severe tricuspid regurgitation (TR) often present with abnormal right ventricular (RV) function and dimensions. - Objectives - The aim of this study was to investigate the impact of RV dysfunction and dilation on clinical outcomes in patients undergoing transcatheter tricuspid edge-to-edge repair (T-TEER). - Methods - Patients from the international EuroTR registry undergoing T-TEER between 2016 and 2023 at 20 heart valve centers across Europe were included. RV dysfunction was defined as tricuspid annular plane systolic excursion <17 mm, and RV dilation was defined as RV mid-diameter >35 mm, determined on baseline echocardiography. - Results - A total of 2,191 patients (mean age 78 ± 7 years, 53% [1,111 of 2,092] women) were analyzed. TR was successfully reduced to a severity grade of ≤2+ in 80% of patients (1,608 of 2,001). In multivariable analysis, significant predictors of mortality after T-TEER included RV dysfunction (HR: 1.05 per 1-mm tricuspid annular plane systolic excursion decrease; 95% CI: 1.03-1.08), RV dilation (HR: 1.02 per 1-mm RV mid-diameter increase; 95% CI: 1.00-1.03), and residual TR after T-TEER (HR: 1.70 for TR grade ≤2; 95% CI: 1.36-2.13). These parameters were also predictive of the combined endpoint of mortality and heart failure hospitalization. The worst prognosis was observed in patients exhibiting both RV dysfunction and dilation. - Conclusions - RV size and function, along with residual TR severity, were significant predictors of clinical outcomes, including all-cause mortality and heart failure hospitalization. Accordingly, early intervention to prevent RV dilation and dysfunction, as well as achieving maximal TR reduction, appears crucial for improving prognosis in patients undergoing T-TEER. |
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| Item Description: | Gesehen am 08.01.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1876-7605 |
| DOI: | 10.1016/j.jcin.2025.05.037 |