JACC. Cardiovascular interventions · 2025
Cardiac Remodeling Following Transcatheter Tricuspid Valve Annuloplasty for Tricuspid Regurgitation: A Real-World, Multicenter Analysis.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Hasse Caroline, von Stein Philipp, Althoff Jan, Curio Jonathan, Schäfer Matthieu, Kirchner Johannes, Rudolph Felix, Gietzen Thorsten, von Stein Jennifer, Wrobel Jan, Iliadis Christos, Gerçek Muhammed, Friedrichs Kai P, Rudolph Volker, Pfister Roman, Baldus Stephan, Koerber Maria I
Аннотация
BACKGROUND: Transcatheter tricuspid valve annuloplasty (TTVA) with the Cardioband has proved to be safe and effective in acutely reducing tricuspid regurgitation (TR). However, long-term outcomes, especially regarding right heart remodeling (RHR), are scarce.
OBJECTIVES: The aim of this study was to assess long-term efficacy as well as RHR following TTVA.
METHODS: This retrospective, multicenter study included consecutive patients undergoing TTVA for severe TR at 2 German high-volume centers from 2019 to 2023. Right atrial and right ventricular (RV) parameters and NYHA functional class were assessed at baseline and follow-up.
RESULTS: A total of 156 patients were included, and the median time to follow-up was 435 days (Q1-Q3: 156-704 days). TR reduction to ≤2+ was observed in 71% and NYHA functional class improved to ≤II in 68% (P < 0.001 for both). Compared with baseline, right atrial area (36.0 ± 10.1 cm2 vs 30.4 ± 10.7 cm2), RV length (67.5 ± 9.4 mm vs 63.7 ± 9.1 mm), RV midventricular dimension (42.6 ± 8.6 mm vs 35.6 ± 7.8 mm), and RV basal dimension (47.8 ± 6.8 mm vs 42.6 ± 7.5 mm)were significantly reduced at follow-up (P < 0.001 for all). Notably, torrential to severe TR reduction still yielded remodeling (RV basal diameter 50 ± 8.1 mm vs 44 ± 8 mm; P = 0.007). RHR was associated with a decrease in vena contracta width (OR: 1.14; 95% CI: 1.03-1.30; P = 0.015).
CONCLUSIONS: TTVA is associated with a significant and sustained reduction of TR for more than 1 year. Additionally, patients demonstrated distinct positive cardiac remodeling and functional improvement.
OBJECTIVES: The aim of this study was to assess long-term efficacy as well as RHR following TTVA.
METHODS: This retrospective, multicenter study included consecutive patients undergoing TTVA for severe TR at 2 German high-volume centers from 2019 to 2023. Right atrial and right ventricular (RV) parameters and NYHA functional class were assessed at baseline and follow-up.
RESULTS: A total of 156 patients were included, and the median time to follow-up was 435 days (Q1-Q3: 156-704 days). TR reduction to ≤2+ was observed in 71% and NYHA functional class improved to ≤II in 68% (P < 0.001 for both). Compared with baseline, right atrial area (36.0 ± 10.1 cm2 vs 30.4 ± 10.7 cm2), RV length (67.5 ± 9.4 mm vs 63.7 ± 9.1 mm), RV midventricular dimension (42.6 ± 8.6 mm vs 35.6 ± 7.8 mm), and RV basal dimension (47.8 ± 6.8 mm vs 42.6 ± 7.5 mm)were significantly reduced at follow-up (P < 0.001 for all). Notably, torrential to severe TR reduction still yielded remodeling (RV basal diameter 50 ± 8.1 mm vs 44 ± 8 mm; P = 0.007). RHR was associated with a decrease in vena contracta width (OR: 1.14; 95% CI: 1.03-1.30; P = 0.015).
CONCLUSIONS: TTVA is associated with a significant and sustained reduction of TR for more than 1 year. Additionally, patients demonstrated distinct positive cardiac remodeling and functional improvement.
Предметные рубрики MeSH
HumansTricuspid Valve InsufficiencyMaleFemaleRetrospective StudiesTreatment OutcomeVentricular RemodelingCardiac CatheterizationAgedTricuspid ValveTime FactorsCardiac Valve AnnuloplastyHeart Valve Prosthesis ImplantationRecovery of FunctionGermanyAtrial RemodelingVentricular Function, RightMiddle AgedAtrial Function, RightAged, 80 and overSeverity of Illness Index