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; ... (2021). Outcomes of transcatheter tricuspid valve intervention by right ventricular function: a multicentre propensity-matched analysis. EuroIntervention, 17(4), e343-e352. Europa Digital & Publishing 10.4244/EIJ-D-21-00191
Full text not available from this repository.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.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Praz, Fabien Daniel, Wild, Mirjam Gauri, Windecker, Stephan |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1774-024X |
Publisher: |
Europa Digital & Publishing |
Language: |
English |
Submitter: |
Nadia Biscozzo |
Date Deposited: |
20 Jan 2022 11:52 |
Last Modified: |
02 Mar 2023 23:35 |
Publisher DOI: |
10.4244/EIJ-D-21-00191 |
PubMed ID: |
33956637 |
URI: |
https://boris.unibe.ch/id/eprint/163206 |
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