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Atrial secondary tricuspid regurgitation: insights into the EuroTR registry

Background - Atrial secondary tricuspid regurgitation (A-STR) has been proposed as an important etiologic subentity of secondary tricuspid regurgitation (STR). Patients with A-STR are frequently treated using transcatheter tricuspid valve edge-to-edge repair (T-TEER). - Objectives - The aims of this...

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Main Authors: Stolz, Lukas (Author) , Kresoja, Karl-Patrik (Author) , Stein, Jennifer von (Author) , Fortmeier, Vera (Author) , Köll, Benedikt (Author) , Rottbauer, Wolfgang (Author) , Kassar, Mohammad (Author) , Goebel, Björn Carsten (Author) , Denti, Paolo (Author) , Achouh, Paul (Author) , Rassaf, Tienush (Author) , Barreiro-Perez, Manuel (Author) , Boekstegers, Peter (Author) , Rück, Andreas (Author) , Doldi, Philipp Maximilian (Author) , Novotny, Julia (Author) , Zdanyte, Monika (Author) , Adamo, Marianna (Author) , Vincent, Flavien (Author) , Schlegel, Philipp (Author) , Bardeleben, Ralph Stephan von (Author) , Stocker, Thomas J. (Author) , Weckbach, Ludwig T. (Author) , Wild, Mirjam (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, Giuliano (Author) , De Carlo, Marco (Author) , Sticchi, Alessandro (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) , 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 Johannes (Author) , Schneider, Leonhard-Moritz (Author) , Felbel, Dominik Jochen (Author) , Salomon, Carsten (Author) , Lapp, Harald (Author) , Puscas, Tania (Author) , Berrebi, Alain (Author) , Mahabadi, Amir Abbas (Author) , Schindhelm, Florian Bernhard Karl-Heinz (Author) , Caneiro-Queija, Berenice (Author) , Echarte, Julio C. (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: 9 December 2024
In: JACC Cardiovascular interventions
Year: 2024, Volume: 17, Issue: 23, Pages: 2781-2791
ISSN:1876-7605
DOI:10.1016/j.jcin.2024.10.028
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jcin.2024.10.028
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S193687982401450X
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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, Roman Pfister, Stephan Baldus, Muhammed Gerçek, Felix Rudolph, Sebastian Ludwig, 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, Jürgen Schreieck, Andreas Goldschmied, Edoardo Pancaldi, Daniela Tomasoni, Natacha Rousse, Samy Aghezzaf, Norbert Frey, Martin Kraus, Dirk Westermann, Sebastian Rosch, Federico Arturi, Andrea Panza, Matteo Mazzola, Cristina Giannini
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Summary:Background - Atrial secondary tricuspid regurgitation (A-STR) has been proposed as an important etiologic subentity of secondary tricuspid regurgitation (STR). Patients with A-STR are frequently treated using transcatheter tricuspid valve edge-to-edge repair (T-TEER). - Objectives - The aims of this study were to evaluate prevalence and outcomes following T-TEER for severe A-STR and to compare the results to patients with nonatrial STR. - Methods - The study included patients from the EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation) registry who underwent T-TEER for STR from 2016 until 2022. A-STR was defined as a ratio of end-systolic right atrial area to right ventricular area ≥1.5 in the presence of preserved right ventricular function (tricuspid annular plane systolic excursion >17 mm). The primary study endpoint was 2-year survival free from heart failure hospitalization. Secondary endpoints were 2-year survival, tricuspid regurgitation (TR) reduction at discharge and 1-year follow-up as well as changes in NYHA functional class. - Results - This study included 641 patients (50% women) with a mean age of 79 ± 7 years. The overall prevalence of A-STR was 31% (n = 196). A-STR was associated with a higher prevalence of atrial fibrillation, less frequent comorbidities, better biventricular function, less leaflet tenting, and larger atria. Although TR severity was comparable at baseline, patients with A-STR had more effective procedural TR reduction (TR ≤2+ in 86.9% vs 80.4% of those with nonatrial STR; P = 0.005). Although NYHA functional class improved in both STR subetiologies, the symptomatic burden was lower in patients with A-STR at the latest available follow-up (NYHA functional class ≥III in 46% of patients with nonatrial STR vs 38% in those with A-STR; P = 0.033). Beyond that, A-STR was associated with higher 2-year survival rates free from heart failure hospitalization (66.3% [Q1-Q3: 58.2%-75.5%] vs 47.5% [Q1-Q3: 41.7%-54.7%] in patients with nonatrial STR; P < 0.001). Median survival follow-up was 379 days [Q1-Q3: 155-697 days]. - Conclusions - A-STR is a common phenotype of STR and is associated with effective TR reduction and symptomatic reduction after T-TEER.
Item Description:Gesehen am 02.02.2026
Physical Description:Online Resource
ISSN:1876-7605
DOI:10.1016/j.jcin.2024.10.028

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