T-TEER significantly reduced tricuspid regurgitation severity and improved clinical outcomes at 1 year, especially in patients with normal RV-PA coupling (TAPSE/SPAP ≥0.40).
Does transcatheter edge-to-edge repair (T-TEER) improve echocardiographic parameters and clinical outcomes in patients with isolated tricuspid regurgitation?
T-TEER reduces TR severity and improves clinical outcomes, particularly in patients with normal baseline RV-PA coupling, though its impact on conventional RV function parameters is limited.
Absolute Event Rate: 0% vs 0%
Abstract Background The relationship between tricuspid regurgitation (TR) reduction after transcatheter edge-to-edge repair (T-TEER), changes in right heart function and outcomes are scarce. Purpose To explore the relationship between reverse remodeling and subsequent outcomes and the associsation between T-TEER, residual TR and outcomes. Methods Changes in echocardiographic parameters from baseline to 1-year, overall and according to TR reduction, were evaluated by a centralized echocardiographic corelab among patients included in the Tri.fr trial. Results 300 patients (78±5 years-old, 53.7% women) were enrolled; 152 patients were allocated to the T-TEER + GDMT group and 148 to the GDMT group. Patients in the T-TEER + GDMT group demonstrated a significant decrease in most of parameters of RV function, whereas those in the GDMT group exhibited no significant changes in RV metrics at 1-year. A stepwise improvement in the clinical composite score was observed with each additional grade of TR reduction. The positive effect of T-TEER on the composite clinical score was observed irrespective of baseline RA volume but only in patients with normal RV-PA coupling (defined by a TAPSE/SPAP ratio ≥0.40) (Figure 1). At 1-year, patients with an improved clinical composite score had a lower RAVi compared to those whose clinical score remained unchanged or worsened (112 78.0; 146 vs. 141 107; 173ml/m², p=0.004). Conclusion Although T-TEER can decrease TR severity, its impact on conventional RV function parameters and RV-PA coupling remains limited. RV functional recovery has a smaller influence on clinical outcomes at 1-year compared to achieving optimal reduction in TR severity (Figure 2).
Coisne et al. (Sat,) reported a other. T-TEER significantly reduced tricuspid regurgitation severity and improved clinical outcomes at 1 year, especially in patients with normal RV-PA coupling (TAPSE/SPAP ≥0.40).
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