The GLIDE Score: One-Year Outcomes Following Tricuspid Transcatheter Edge-to-Edge Repair

Background The GLIDE score is a 5-point imaging-based tool to predict residual tricuspid regurgitation (TR) after tricuspid transcatheter edge-to-edge repair (T-TEER). Lower residual TR is associated with better prognosis, but long-term associations between GLIDE score and outcomes are uncertain. Methods We performed an analysis of a multinational registry of patients undergoing T-TEER for severe or greater TR from January 2017 to November 2022. GLIDE scores were assessed using preprocedural transesophageal echocardiography. The primary endpoint was a composite of all-cause mortality or heart failure hospitalization (HFH) at 1 year, and the secondary endpoints included TR grade of moderate or less at 1 year. Results In 336 patients (81 [interquartile range 77–84] years; 44.6% male, TRI-SCORE 5 [interquartile range 4–6]), survival and HFH follow-up at 1 year was available in 90.5%. One-year mortality was 15.8%. The GLIDE score was significantly associated with the combined primary endpoint (hazard ratio: 1.20; 95% CI 1.03–1.40; p = 0.019), even after adjustment for TRI-SCORE. Freedom from death or HFH was significantly higher among patients with GLIDE scores ≤1 compared to those ≥2 ( p = 0.032). Of the 251 1-year survivors, follow-up echocardiography was available in 170 (68%). The GLIDE score predicted 1-year TR severity (area under the receiver operating characteristic curve: 0.73; 95% CI 0.65–0.81), with moderate or less residual TR achieved in 80.6%, 54.9%, and 18.8% of patients with GLIDE scores of 0–1, 2–3, and ≥4, respectively. Conclusions The GLIDE score is associated with 1-year survival and HFH after T-TEER as well as ≤ moderate TR.