Natural history of severe tricuspid regurgitation: Outcomes after transcatheter tricuspid valve intervention compared to medical therapy

Sean Cai, Nicolas Bowers, Arjan Dhoot, Edwin C. Ho, Geraldine Ong, Janine Eckstein, Jeremy Edwards, Neil Fam, Kim A. Connelly

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Aims: We aimed to identify the clinical characteristics and examine outcomes in patients with significant tricuspid regurgitation (TR) who received transcatheter tricuspid valve intervention (TTVI) compared with guideline directed medical therapy (GDMT). Methods and results: Between 2015 and 2019, 124 patients with symptomatic severe TR were assessed at St. Michael's Hospital. Seventy-one patients were ineligible and received GDMT only while 53 patients received TTVI and GDMT. During follow-up, TTVI was associated with significant improvements in NYHA functional class and 6-min walk distance (p <.001). GDMT patients had lower survival (46.9% vs 75.1%, p =.047) and lower freedom from heart failure hospitalization (HHF) and mortality (33.2% vs 62.7%, p =.027), higher incidences per 100 person-year of gastrointestinal bleeding [15.58 (95% CI 8.90–25.31) vs 4.24 (95% CI 0.85–12.37), p =.04] and acute kidney injury [36.98 (95% CI 26.17–50.76) vs 14.12 (95% CI 6.76–25.96), p =.001] compared with TTVI patients. Conclusion: TTVI in addition to GDMT was effective at improving TR symptoms, functional status, and was associated with lower rates of all-cause mortality, the combined endpoint of HHF and mortality, AKI and GI bleeding. Future randomized controlled trials on TTVI are needed.

Original languageEnglish (US)
Pages (from-to)49-54
Number of pages6
JournalInternational Journal of Cardiology
Volume320
DOIs
StatePublished - Dec 1 2020
Externally publishedYes

Keywords

  • Heart failure
  • Tricuspid regurgitation
  • TTVI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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