Edge-to-edge tricuspid valve repair and heart failure hospitalizations: the TRI-SPA registry

Abstract Background The prognostic impact of a history of heart failure hospitalizations (HFH) in patients undergoing transcatheter tricuspid edge-to-edge repair (T-TEER) has been scarcely studied. This study presents the results of the TRI-SPA registry, which includes data from 15 Spanish centers. Purpose The aim of this study was to investigate the prognostic role of heart failure (HF) history in patients with tricuspid regurgitation (TR) underwent transcatheter T-TEER. Methods A multicenter, retrospective registry was conducted, including patients who underwent T-TEER between June 2020 and May 2023. Patients were classified into the 3 groups, based on the number of HFH in the 12 months prior to the procedure: no HFH, 1 HFH, and 1 HFH (recurrent). The primary endpoint was all-cause mortality and HFH. Results Of the 262 patients included, 167 (63.7%) had no history of HFH, 60 (22.9%) had 1 HFH, and 35 (13.4%) had 1 HFH. Patients with 1 hospitalization had more comorbidities, higher surgical risk, and worse functional class; however, no significant differences were observed in the severity of tricuspid regurgitation either at baseline or after T-TEER. After a median follow-up of 365 160-643 days, patients with recurrent HFH had higher rates of the composite outcome (9.9%, 16.7%, and 43.1%, respectively; P .001), as well as higher mortality rates (P = .036) and HFH (P .001). The number of HFH significantly decreased in the 12 months following T-TEER compared with the 12 months prior (P = .001). Conclusions Recurrent HFH within the 12 months prior to the procedure was associated with a higher risk of adverse clinical events during follow-up. T-TEER significantly reduced the number of hospitalizations during the follow-up period.K-M curves of the primary outcome