Outcomes of transcatheter tricuspid valve intervention by right ventricular function: a multicentre propensity-matched analysis
Standard
Outcomes of transcatheter tricuspid valve intervention by right ventricular function: a multicentre propensity-matched analysis. / Schlotter, Florian; Miura, Mizuki; Kresoja, Karl-Patrik; Alushi, Brunilda; Alessandrini, Hannes; Attinger-Toller, Adrian; Besler, Christian; Biasco, Luigi; Braun, Daniel; Brochet, Eric; Connelly, Kim A; de Bruijn, Sabine; Denti, Paolo; Estevez-Loureiro, Rodrigo; Fam, Neil; Gavazzoni, Mara; Himbert, Dominique; Ho, Edwin C; Juliard, Jean-Michel; Kalbacher, Daniel; Kaple, Ryan; Kreidel, Felix; Latib, Azeem; Lubos, Edith; Ludwig, Sebastian; Mehr, Michael; Monivas, Vanessa; Nazif, Tamim M; Nickenig, Georg; Pedrazzini, Giovanni; Pozzoli, Alberto; Praz, Fabien; Puri, Rishi; Rodés-Cabau, Josep; Rommel, Karl-Philipp; Schäfer, Ulrich; Schofer, Joachim; Sievert, Horst; Tang, Gilbert H L; Thiele, Holger; Unterhuber, Matthias; Vahanian, Alec; von Bardeleben, Ralph Stephan; von Roeder, Maximilian; Webb, John G; Weber, Marcel; Wild, Mirjam G; Windecker, Stephan; Zuber, Michel; Hausleiter, Jörg; Maisano, Francesco; Leon, Martin B; Hahn, Rebecca T; Lauten, Alexander; Taramasso, Maurizio; Lurz, Philipp; TriValve Registry.
in: EUROINTERVENTION, Jahrgang 17, Nr. 4, 20.07.2021, S. e343-e352.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Outcomes of transcatheter tricuspid valve intervention by right ventricular function: a multicentre propensity-matched analysis
AU - Schlotter, Florian
AU - Miura, Mizuki
AU - Kresoja, Karl-Patrik
AU - Alushi, Brunilda
AU - Alessandrini, Hannes
AU - Attinger-Toller, Adrian
AU - Besler, Christian
AU - Biasco, Luigi
AU - Braun, Daniel
AU - Brochet, Eric
AU - Connelly, Kim A
AU - de Bruijn, Sabine
AU - Denti, Paolo
AU - Estevez-Loureiro, Rodrigo
AU - Fam, Neil
AU - Gavazzoni, Mara
AU - Himbert, Dominique
AU - Ho, Edwin C
AU - Juliard, Jean-Michel
AU - Kalbacher, Daniel
AU - Kaple, Ryan
AU - Kreidel, Felix
AU - Latib, Azeem
AU - Lubos, Edith
AU - Ludwig, Sebastian
AU - Mehr, Michael
AU - Monivas, Vanessa
AU - Nazif, Tamim M
AU - Nickenig, Georg
AU - Pedrazzini, Giovanni
AU - Pozzoli, Alberto
AU - Praz, Fabien
AU - Puri, Rishi
AU - Rodés-Cabau, Josep
AU - Rommel, Karl-Philipp
AU - Schäfer, Ulrich
AU - Schofer, Joachim
AU - Sievert, Horst
AU - Tang, Gilbert H L
AU - Thiele, Holger
AU - Unterhuber, Matthias
AU - Vahanian, Alec
AU - von Bardeleben, Ralph Stephan
AU - von Roeder, Maximilian
AU - Webb, John G
AU - Weber, Marcel
AU - Wild, Mirjam G
AU - Windecker, Stephan
AU - Zuber, Michel
AU - Hausleiter, Jörg
AU - Maisano, Francesco
AU - Leon, Martin B
AU - Hahn, Rebecca T
AU - Lauten, Alexander
AU - Taramasso, Maurizio
AU - Lurz, Philipp
AU - TriValve Registry
PY - 2021/7/20
Y1 - 2021/7/20
N2 - BACKGROUND: Tricuspid regurgitation (TR) has a poor prognosis and limited treatment options and is frequently accompanied by right ventricular (RV) dysfunction. Transcatheter tricuspid valve interventions (TTVI) to reduce TR have been shown to be safe and feasible with encouraging early results. Patient selection for TTVI remains challenging, with the role of right ventricular (RV) function being unknown.AIMS: The aims of this study were 1) to investigate survival in a TTVI-treated patient population and a conservatively treated TR population, and 2) to evaluate the outcome of TTVI as compared to conservative treatment stratified according to the degree of RV function.METHODS: We studied 684 patients from the multicentre TriValve cohort (TTVI cohort) and compared them to 914 conservatively treated patients from two tertiary care centres. Propensity matching identified 213 pairs of patients with severe TR. As we observed a non-linear relationship of RV function and TTVI outcome, we stratified patients according to tricuspid annular plane systolic excursion (TAPSE) to preserved (TAPSE >17 mm), mid-range (TAPSE 13-17 mm) and reduced (TAPSE <13 mm) RV function. The primary outcome was one-year all-cause mortality.RESULTS: TTVI was associated with a survival benefit in patients with severe TR when compared to matched controls (one-year mortality rate: 13.1% vs 25.8%; p=0.031). Of the three RV subgroups, only in patients with mid-range RV function was TTVI associated with an improved survival (p log-rank 0.004). In these patients, procedural success was associated with a reduced hazard ratio for all-cause mortality (HR 0.22; 95% CI: 0.09, 0.57).CONCLUSIONS: TTVI is associated with reduced mortality compared to conservative therapy and might exert its highest treatment effect in patients with mid-range reduced RV function.
AB - BACKGROUND: Tricuspid regurgitation (TR) has a poor prognosis and limited treatment options and is frequently accompanied by right ventricular (RV) dysfunction. Transcatheter tricuspid valve interventions (TTVI) to reduce TR have been shown to be safe and feasible with encouraging early results. Patient selection for TTVI remains challenging, with the role of right ventricular (RV) function being unknown.AIMS: The aims of this study were 1) to investigate survival in a TTVI-treated patient population and a conservatively treated TR population, and 2) to evaluate the outcome of TTVI as compared to conservative treatment stratified according to the degree of RV function.METHODS: We studied 684 patients from the multicentre TriValve cohort (TTVI cohort) and compared them to 914 conservatively treated patients from two tertiary care centres. Propensity matching identified 213 pairs of patients with severe TR. As we observed a non-linear relationship of RV function and TTVI outcome, we stratified patients according to tricuspid annular plane systolic excursion (TAPSE) to preserved (TAPSE >17 mm), mid-range (TAPSE 13-17 mm) and reduced (TAPSE <13 mm) RV function. The primary outcome was one-year all-cause mortality.RESULTS: TTVI was associated with a survival benefit in patients with severe TR when compared to matched controls (one-year mortality rate: 13.1% vs 25.8%; p=0.031). Of the three RV subgroups, only in patients with mid-range RV function was TTVI associated with an improved survival (p log-rank 0.004). In these patients, procedural success was associated with a reduced hazard ratio for all-cause mortality (HR 0.22; 95% CI: 0.09, 0.57).CONCLUSIONS: TTVI is associated with reduced mortality compared to conservative therapy and might exert its highest treatment effect in patients with mid-range reduced RV function.
U2 - 10.4244/EIJ-D-21-00191
DO - 10.4244/EIJ-D-21-00191
M3 - SCORING: Journal article
C2 - 33956637
VL - 17
SP - e343-e352
JO - EUROINTERVENTION
JF - EUROINTERVENTION
SN - 1774-024X
IS - 4
ER -