Left-sided heart failure determines outcomes in patients with severe tricuspid regurgitation undergoing percutaneous repair - PubMed
3 hours ago
- #Heart Failure
- #Tricuspid Regurgitation
- #Percutaneous Repair
- Left-sided heart failure (HF) significantly impacts outcomes in patients with severe tricuspid regurgitation (TR) undergoing percutaneous repair.
- Tricuspid valve transcatheter edge-to-edge repair (T-TEER) is a treatment for severe TR, but the role of coexisting HF phenotypes remains unclear.
- Patients were stratified by left ventricular ejection fraction (LVEF) into reduced/mildly reduced (HFmrEF/HFrEF <50%) and preserved (≥50%).
- Those with preserved LVEF were further divided by pulmonary capillary wedge pressure (PCWP) into HFpEF (>15 mmHg) and non-overt left-sided HF (≤15 mmHg).
- Procedural success (TR ≤moderate) was highest in non-overt left-sided HF (87%) and lowest in HFmrEF/HFrEF (78%).
- Estimated 2-year mortality was 25.0% in HFmrEF/HFrEF, 20.3% in HFpEF, and 13.1% in non-overt left-sided HF.
- Procedural success was associated with improved outcomes in all groups (p<0.01).
- Predictors of survival differed by phenotype: right ventricular function for HFmrEF/HFrEF, right-sided pressures for HFpEF, and baseline TR severity for non-overt left-sided HF.
- Consideration of left-sided pathologies in patients with significant TR is important as outcomes and predictors for survival differ.