Why the study?
To describe the longitudinal impact of T-TEER on different dimensions and items of quality of life compared with OMT alone in patients with TR.
Does T-TEER added to OMT improve quality of life in patients with severe symptomatic tricuspid regurgitation compared to OMT alone?
Does T-TEER added to OMT improve quality of life in patients with severe symptomatic tricuspid regurgitation compared to OMT alone?
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We clearly showed the benefits of T-TEER, as seen in the TRILUMINATE trial, but using T-TEER as part of a global approach and treating heart failure with guideline-directed medical management and follow-up. A key message of the Tri.fr trial is that implementing rigorous multidisciplinary medical management resulted in a low event rate, even in very ill patients with secondary TR. Using T-TEER with optimal medical management also led to important quality-of-life improvements.”
“Transcatheter edge-to-edge repair is something that probably we have to consider in patients with severe tricuspid regurg, but on top of optimized medical treatment. We still have to optimize medical treatment because when we compare the result that we got and the result from previous studies and registries, it's so impressive to see that the death rate and the rate of hospitalization is much lower in this trial than before.”
“TRI.Fr is a positive prospective study, confirming a clear benefit for patients suffering from severe tricuspid regurgitation. It is important to note that medical treatment and strict monitoring of these patients, who are often in advanced heart failure, are equally crucial. What seems to be confirmed is that tricuspid regurgitation treatment with clips effectively complements medical therapy and is a therapeutic option that must be recognised, as overlooking tricuspid regurgitation in our patients should be avoided at all costs.”
T-TEER added to medical therapy provides substantial and sustained improvements in patient-reported quality of life over 1 year in patients with severe symptomatic tricuspid regurgitation.
AIMS: In the Tri.FR trial, tricuspid transcatheter edge-to-edge repair (T-TEER) reduced severity of tricuspid regurgitation (TR) and improved the composite clinical score, driven by patient-reported outcomes. The purpose of this study was to describe the longitudinal impact of T-TEER on different dimensions and items of quality of life compared with guideline-directed medical treatment (OMT) alone. METHODS AND RESULTS: Patients were randomized to T-TEER +OMT (n = 152) or OMT alone (n = 148). Health status was assessed at baseline, 6 weeks, 6 months, and 1 year using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Minnesota Living with Heart Failure (MLHF) Questionnaire. Mixed effects linear regression analysed changes over time. Patients receiving T-TEER + OMT experienced a significant increase in KCCQ overall summary score (KCCQ-OS) at all time points: +17.0 points (95% confidence interval [CI] 13.1-21.5) at 6 weeks, +15.9 points (95% CI 11.2-20.6) at 6 months, and +18.7 points (95% CI 13.8-23.6) at 1 year. The mean between-group difference in KCCQ-OS was +10.3 points (95% CI 5.6-15.0) in favour of T-TEER + OMT, evident at 6 weeks and sustained for 1 year. Similarly, MLHF total scores improved significantly in the T-TEER group (mean between-group difference -8.61 points, 95% CI -12.6 to -4.6), including physical (-3.9, 95% CI -5.9 to -1.9) and emotional (-2.2, 95% CI -3.4 to -1.0) subscales. CONCLUSIONS: Compared with OMT alone, T-TEER resulted in substantial, multidimensional, and sustained improvements in patient-reported quality of life. These findings reinforce the value of T-TEER in managing severe symptomatic TR.
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Istrătoaie et al. (2025) studied this question.
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