Lukas Stolz, Karl-Patrik Kresoja, Jennifer von Stein, Vera Fortmeier, Benedikt Koell, Wolfgang Rottbauer, Mohammad Kassar, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Manuel Barreiro-Perez, Peter Boekstegers, Andreas Rück, Philipp M Doldi, Julia Novotny, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Lurz, Ralph-Stephan von Bardeleben, Thomas J Stocker, Ludwig T Weckbach, Mirjam G Wild, Christian Besler, Stephanie Brunner, Stefan Toggweiler, Julia Grapsa, Tiffany Patterson, Holger Thiele, Tobias Kister, Giuseppe Tarantini, Giulia Masiero, Marco De Carlo, Alessandro Sticchi, Mathias H Konstandin, Eric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Peter Luedike, Nicole Karam, Francesco Maisano, Philipp Lauten, Fabien Praz, Mirjam Kessler, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Philipp Lurz, Jörg Hausleiter, Roman Pfister, Stephan Baldus, Muhammed Gerçek, Felix Rudolph, Sebastian Ludwig, Christoph Pauschinger, Leonhard-Moritz Schneider, Dominik Felbel, Carsten Salomon, Harald Lapp, Tania Puscas, Alain Berrebi, Amir Abbas Mahabadi, Florian Schindhelm, Berenice Caneiro-Queija, Julio C Echarte, Jürgen Schreieck, Andreas Goldschmied, Edoardo Pancaldi, Daniela Tomasoni, Natacha Rousse, Samy Aghezzaf, Norbert Frey, Martin Kraus, Dirk Westermann, Sebastian Rosch, Federico Arturi, Andrea Panza, Matteo Mazzola, Cristina Giannini
{"title":"Impact of Pulmonary Hypertension on Outcomes after Transcatheter Tricuspid Valve Edge-to-Edge Repair.","authors":"Lukas Stolz, Karl-Patrik Kresoja, Jennifer von Stein, Vera Fortmeier, Benedikt Koell, Wolfgang Rottbauer, Mohammad Kassar, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Manuel Barreiro-Perez, Peter Boekstegers, Andreas Rück, Philipp M Doldi, Julia Novotny, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Lurz, Ralph-Stephan von Bardeleben, Thomas J Stocker, Ludwig T Weckbach, Mirjam G Wild, Christian Besler, Stephanie Brunner, Stefan Toggweiler, Julia Grapsa, Tiffany Patterson, Holger Thiele, Tobias Kister, Giuseppe Tarantini, Giulia Masiero, Marco De Carlo, Alessandro Sticchi, Mathias H Konstandin, Eric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Peter Luedike, Nicole Karam, Francesco Maisano, Philipp Lauten, Fabien Praz, Mirjam Kessler, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Philipp Lurz, Jörg Hausleiter, Roman Pfister, Stephan Baldus, Muhammed Gerçek, Felix Rudolph, Sebastian Ludwig, Christoph Pauschinger, Leonhard-Moritz Schneider, Dominik Felbel, Carsten Salomon, Harald Lapp, Tania Puscas, Alain Berrebi, Amir Abbas Mahabadi, Florian Schindhelm, Berenice Caneiro-Queija, Julio C Echarte, Jürgen Schreieck, Andreas Goldschmied, Edoardo Pancaldi, Daniela Tomasoni, Natacha Rousse, Samy Aghezzaf, Norbert Frey, Martin Kraus, Dirk Westermann, Sebastian Rosch, Federico Arturi, Andrea Panza, Matteo Mazzola, Cristina Giannini","doi":"10.1016/j.jcin.2024.10.023","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Data regarding the association of pulmonary hypertension (PH) and outcomes in patients undergoing transcatheter tricuspid valve edge-to-edge repair (T-TEER) are scarce.</p><p><strong>Objectives: </strong>To 1) investigate the impact of PH on outcomes after T-TEER and 2) to shed further light into the role of pre- and postcapillary PH in patients undergoing T-TEER for relevant tricuspid regurgitation (TR).</p><p><strong>Methods: </strong>The study included patients from the EuroTR registry (NCT06307262) who underwent T-TEER for relevant TR from 2016 until 2023 with available invasive evaluation of sPAP using right heart catheterization. Study endpoints were procedural TR reduction, improvement in New York Heart Association (NYHA) function class and a combined endpoint of death or heart failure hospitalization (HFH) at two-years.</p><p><strong>Results: </strong>Among a total of 1230 patients (mean age 78.6 ±7.0 years; 51.4% women) increasing systolic pulmonary artery pressure (sPAP) was independently associated with increasing rates of two-year death or HFH (hazard ratio 1.027, 95% confidence interval 1.003-1.052, p=0.030; median survival follow up 343 (114-645) days). No significant survival differences were observed for patients with pre- vs. postcapillary PH. Sensitivity analysis revealed a sPAP value of 46 mmHg as optimized threshold for prediction of death or HFH. Being observed in 526 patients (42.8%), elevated sPAP > 46 mmHg was associated with more severe heart failure symptoms at baseline and follow-up. Importantly, NYHA functional class and TR severity significantly improved irrespective of PH.</p><p><strong>Conclusion: </strong>PH is an important outcome predictor in patients undergoing T-TEER for relevant TR. In contrast to previous studies, no significant differences were observed for patients with pre- and postcapillary PH in terms of survival free from HFH.</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Cardiovascular interventions","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jcin.2024.10.023","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Data regarding the association of pulmonary hypertension (PH) and outcomes in patients undergoing transcatheter tricuspid valve edge-to-edge repair (T-TEER) are scarce.
Objectives: To 1) investigate the impact of PH on outcomes after T-TEER and 2) to shed further light into the role of pre- and postcapillary PH in patients undergoing T-TEER for relevant tricuspid regurgitation (TR).
Methods: The study included patients from the EuroTR registry (NCT06307262) who underwent T-TEER for relevant TR from 2016 until 2023 with available invasive evaluation of sPAP using right heart catheterization. Study endpoints were procedural TR reduction, improvement in New York Heart Association (NYHA) function class and a combined endpoint of death or heart failure hospitalization (HFH) at two-years.
Results: Among a total of 1230 patients (mean age 78.6 ±7.0 years; 51.4% women) increasing systolic pulmonary artery pressure (sPAP) was independently associated with increasing rates of two-year death or HFH (hazard ratio 1.027, 95% confidence interval 1.003-1.052, p=0.030; median survival follow up 343 (114-645) days). No significant survival differences were observed for patients with pre- vs. postcapillary PH. Sensitivity analysis revealed a sPAP value of 46 mmHg as optimized threshold for prediction of death or HFH. Being observed in 526 patients (42.8%), elevated sPAP > 46 mmHg was associated with more severe heart failure symptoms at baseline and follow-up. Importantly, NYHA functional class and TR severity significantly improved irrespective of PH.
Conclusion: PH is an important outcome predictor in patients undergoing T-TEER for relevant TR. In contrast to previous studies, no significant differences were observed for patients with pre- and postcapillary PH in terms of survival free from HFH.
期刊介绍：
JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.
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