TY - JOUR
T1 - Value of Echocardiographic Right Ventricular and Pulmonary Pressure Assessment in Predicting Transcatheter Tricuspid Repair Outcome
AU - Karam, Nicole
AU - Mehr, Michael
AU - Taramasso, Maurizio
AU - Besler, Christian
AU - Ruf, Tobias
AU - Connelly, Kim A.
AU - Weber, Marcel
AU - Yzeiraj, Ermela
AU - Schiavi, Davide
AU - Mangieri, Antonio
AU - Vaskelyte, Laura
AU - Alessandrini, Hannes
AU - Deuschl, Florian
AU - Brugger, Nicolas
AU - Ahmad, Hasan
AU - Ho, Edwin
AU - Biasco, Luigi
AU - Orban, Mathias
AU - Deseive, Simon
AU - Braun, Daniel
AU - Gavazzoni, Mara
AU - Rommel, Karl Philipp
AU - Pozzoli, Alberto
AU - Frerker, Christian
AU - Näbauer, Michael
AU - Massberg, Steffen
AU - Pedrazzini, Giovanni
AU - Tang, Gilbert H.L.
AU - Windecker, Stephan
AU - Schäfer, Ulrich
AU - Kuck, Karl Heinz
AU - Sievert, Horst
AU - Denti, Paolo
AU - Latib, Azeem
AU - Schofer, Joachim
AU - Nickenig, Georg
AU - Fam, Neil
AU - von Bardeleben, Stephan
AU - Lurz, Philipp
AU - Maisano, Francesco
AU - Hausleiter, Jörg
N1 - Publisher Copyright:
© 2020 American College of Cardiology Foundation
PY - 2020/5/25
Y1 - 2020/5/25
N2 - Objectives: The aim of this study was to assess the value of echocardiographic right ventricular (RV) and systolic pulmonary artery pressure (sPAP) assessment in predicting transcatheter tricuspid edge-to-edge valve repair (TTVR) outcome. Background: RV dysfunction and pulmonary hypertension are associated with poor prognosis and are systematically sought during tricuspid regurgitation evaluation. The value of echocardiographic assessment in predicting TTVR outcome is unknown. Methods: Data were taken from the TriValve (Transcatheter Tricuspid Valve Therapies) registry, which includes patients undergoing TTVR at 14 European and North American centers. The primary outcome was 1-year survival free from hospitalization for heart failure, and secondary outcomes were 1-year survival and absence of hospital admission for heart failure at 1 year. Results: Overall, 249 patients underwent TTVR between June 2015 and 2018 (mean tricuspid annular plane systolic excursion [TAPSE] 15.8 ± 15.3 mm, mean sPAP 43.6 ± 16.0 mm Hg). Tricuspid regurgitation grade ≥3+ was found in 96.8% of patients at baseline and 29.4% at final follow-up; 95.6% were in New York Heart Association functional class III or IV initially, compared with 34.3% at follow-up (p < 0.05). Final New York Heart Association functional class did not differ among TAPSE and sPAP quartiles, even when both low TAPSE and high sPAP were present. Rates of 1-year survival and survival free from hospitalization for heart failure were 83.9% and 78.7%, respectively, without significant differences according to baseline echocardiographic RV characteristics (TAPSE, fractional area change, and end-diastolic area) and sPAP (p > 0.05 for all). Conclusions: TTVR provides clinical improvement, with 1-year survival free from hospital readmission >75% in patients with severe tricuspid regurgitation. Conventional echocardiographic parameters used to assess RV function and sPAP did not predict clinical outcome after TTVR.
AB - Objectives: The aim of this study was to assess the value of echocardiographic right ventricular (RV) and systolic pulmonary artery pressure (sPAP) assessment in predicting transcatheter tricuspid edge-to-edge valve repair (TTVR) outcome. Background: RV dysfunction and pulmonary hypertension are associated with poor prognosis and are systematically sought during tricuspid regurgitation evaluation. The value of echocardiographic assessment in predicting TTVR outcome is unknown. Methods: Data were taken from the TriValve (Transcatheter Tricuspid Valve Therapies) registry, which includes patients undergoing TTVR at 14 European and North American centers. The primary outcome was 1-year survival free from hospitalization for heart failure, and secondary outcomes were 1-year survival and absence of hospital admission for heart failure at 1 year. Results: Overall, 249 patients underwent TTVR between June 2015 and 2018 (mean tricuspid annular plane systolic excursion [TAPSE] 15.8 ± 15.3 mm, mean sPAP 43.6 ± 16.0 mm Hg). Tricuspid regurgitation grade ≥3+ was found in 96.8% of patients at baseline and 29.4% at final follow-up; 95.6% were in New York Heart Association functional class III or IV initially, compared with 34.3% at follow-up (p < 0.05). Final New York Heart Association functional class did not differ among TAPSE and sPAP quartiles, even when both low TAPSE and high sPAP were present. Rates of 1-year survival and survival free from hospitalization for heart failure were 83.9% and 78.7%, respectively, without significant differences according to baseline echocardiographic RV characteristics (TAPSE, fractional area change, and end-diastolic area) and sPAP (p > 0.05 for all). Conclusions: TTVR provides clinical improvement, with 1-year survival free from hospital readmission >75% in patients with severe tricuspid regurgitation. Conventional echocardiographic parameters used to assess RV function and sPAP did not predict clinical outcome after TTVR.
KW - edge-to-edge repair
KW - outcome
KW - pulmonary artery pressure
KW - right ventricular function
KW - tricuspid regurgitation
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U2 - 10.1016/j.jcin.2020.02.028
DO - 10.1016/j.jcin.2020.02.028
M3 - Article
C2 - 32360260
AN - SCOPUS:85084359370
SN - 1936-8798
VL - 13
SP - 1251
EP - 1261
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 10
ER -