Prognostic Value of Tricuspid Valve Gradient After Transcatheter Edge-to-Edge Repair: Insights From the TriValve Registry.

Autor:	Coisne A; Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA; Universitè Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France., Scotti A; Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA., Taramasso M; Heart Center Hirslanden Zürich, Zürich, Switzerland., Granada JF; Cardiovascular Research Foundation, New York, New York, USA., Ludwig S; Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA; Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany., Rodés-Cabau J; Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada., Lurz P; Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany., Hausleiter J; Medical Clinic and Polyclinic I, University Hospital of Munich, Munich, Germany., Fam N; Division of Cardiology, Toronto Heart Center, St. Michael's Hospital, Toronto, Ontario, Canada., Kodali SK; Division of Cardiology, Columbia University Medical Center-NewYork Presbyterian Hospital, New York, New York, USA., Pozzoli A; Division of Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland., Alessandrini H; Asklepios Clinic St. Georg, Hamburg, Germany., Biasco L; Azienda Sanitaria Locale Torino 4, Ciriè, Italy; Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland., Brochet E; Division of Cardiology, Bichat Hospital, Paris, France., Denti P; Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy., Estevez-Loureiro R; Interventional Cardiology Clinic, University Hospital Alvaro Cunqueiro, Vigo, Spain., Frerker C; University Heart Center, Schleswig-Holstein University, Lübeck, Germany., Ho EC; Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA., Monivas V; Division of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain., Nickenig G; Division of Cardiology, Bonn University Hospital, Bonn, Germany., Praz F; Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland., Puri R; Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Sievert H; Division of Cardiology, Cardiovascular Center Frankfurt, Frankfurt am Main, Germany., Tang GHL; Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA., Andreas M; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria., Von Bardeleben RS; Division of Cardiology, University Medical Center, Mainz, Germany., Rommel KP; Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany., Muntané-Carol G; Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada., Gavazzoni M; Heart Center Hirslanden Zürich, Zürich, Switzerland., Braun D; Medical Clinic and Polyclinic I, University Hospital of Munich, Munich, Germany., Lubos E; Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany., Kalbacher D; Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Luebeck/Kiel, Germany., Connelly KA; Division of Cardiology, Toronto Heart Center, St. Michael's Hospital, Toronto, Ontario, Canada., Juliard JM; Division of Cardiology, Bichat Hospital, Paris, France., Harr C; Asklepios Clinic St. Georg, Hamburg, Germany., Pedrazzini G; Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland; Division of Cardiology, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland., Philippon F; Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada., Schofer J; Asklepios Clinic St. Georg, Hamburg, Germany., Thiele H; Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany., Unterhuber M; Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany., Himbert D; Division of Cardiology, Bichat Hospital, Paris, France., Alcázar MU; Division of Cardiology, Bichat Hospital, Paris, France., Wild MG; Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland., Jorde U; Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA., Windecker S; Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland., Maisano F; Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy., Leon MB; Cardiovascular Research Foundation, New York, New York, USA; Division of Cardiology, Columbia University Medical Center-NewYork Presbyterian Hospital, New York, New York, USA., Hahn RT; Cardiovascular Research Foundation, New York, New York, USA; Division of Cardiology, Columbia University Medical Center-NewYork Presbyterian Hospital, New York, New York, USA., Latib A; Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. Electronic address: alatib@gmail.com.
Jazyk:	angličtina
Zdroj:	JACC. Cardiovascular interventions [JACC Cardiovasc Interv] 2023 Mar 10. Date of Electronic Publication: 2023 Mar 10.
DOI:	10.1016/j.jcin.2023.01.375
Abstrakt:	Background: Data regarding the impact of the tricuspid valve gradient (TVG) after tricuspid transcatheter edge-to-edge repair (TEER) are scarce. Objectives: This study sought to evaluate the association between the mean TVG and clinical outcomes among patients who underwent tricuspid TEER for significant tricuspid regurgitation. Methods: Patients with significant tricuspid regurgitation who underwent tricuspid TEER within the TriValve (International Multisite Transcatheter Tricuspid Valve Therapies) registry were divided into quartiles based on the mean TVG at discharge. The primary endpoint was the composite of all-cause mortality and heart failure hospitalization. Outcomes were assessed up to the 1-year follow-up. Results: A total of 308 patients were included from 24 centers. Patients were divided into quartiles of the mean TVG as follows: quartile 1 (n = 77), 0.9 ± 0.3 mm Hg; quartile 2 (n = 115), 1.8 ± 0.3 mm Hg; quartile 3 (n = 65), 2.8 ± 0.3 mm Hg; and quartile 4 (n = 51), 4.7 ± 2.0 mm Hg. The baseline TVG and the number of implanted clips were associated with a higher post-TEER TVG. There was no significant difference across TVG quartiles in the 1-year composite endpoint (quartiles 1-4: 35%, 30%, 40%, and 34%, respectively; P = 0.60) or the proportion of patients in New York Heart Association class III to IV at the last follow-up (P = 0.63). The results were similar after adjustment for clinical and echocardiographic characteristics (composite endpoint quartile 4 vs quartile 1-quartile 3 adjusted HR: 1.05; 95% CI: 0.52-2.12; P = 0.88) or exploring post-TEER TVG as a continuous variable. Conclusions: In this retrospective analysis of the TriValve registry, an increased discharge TVG was not significantly associated with adverse outcomes after tricuspid TEER. These findings apply for the explored TVG range and up to the 1-year follow-up. Further investigations on higher gradients and longer follow-up are needed to better guide the intraprocedural decision-making process. Competing Interests: Funding Support and Author Disclosures Dr Coisne has served as a consultant for Abbott; and has received speaker fees from Abbott and GE Healthcare. Dr Scotti has served as a consultant for NeoChord Inc; and has received consulting fees from NeoChord Inc. Dr Taramasso has served as a consultant for Abbott Vascular, Boston Scientific, 4Tech, and CoreMedic; and has received speaker honoraria from Edwards Lifesciences. Dr Ludwig has received travel compensation from Edwards Lifesciences. Dr Rodés-Cabau has received institutional research grants from Edwards Lifesciences. Dr Lurz has received speaker fees from Abbott. Dr Hausleiter has received speaker honoraria from Abbott Vascular and Edwards Lifesciences. Dr Kodali has served on the scientific advisory board for Microinterventional Devices, Dura Biotech, Thubrikar Aortic Valve, and Supira; has served as a consultant for Meril Lifesciences, Admedus, Medtronic, and Boston Scientific; has served on the steering committee for Edwards Lifesciences and Abbott Vascular; has received honoraria from Meril Lifesciences, Admedus, Abbott Vascular, and Dura Biotech; and owns equity in Dura Biotech, Thubrikar Aortic Valve, Supira, and MID. Dr Alessandrini has received consulting fees from Abbott and Edwards LifeSciences. Dr Brochet has received speaker fees from Abbott Vascular. Dr Denti has served as a consultant for Abbott Vascular, 4Tech, Neovasc, and InnovHeart; and has received honoraria from Abbott and Edwards Lifesciences. Dr Estévez- Loureiro has received speaker fees from Abbott, Boston, and Edwards Lifesciences. Dr Ho has served as a consultant for NeoChord Inc; and has received consulting fees from NeoChord Inc. Dr Praz has received travel expenses from Edwards Lifesciences, Abbott Vascular, and Polares Medical. Dr Sievert has received study honoraria, travel expenses, and consulting fees from 4Tech Cardio, Abbott, Ablative Solutions, Ancora Heart, Bavaria Medizin Technologie, Bioventrix, Boston Scientific, Carag, Cardiac Dimensions, Celonova, Comed BV, Contego, CVRx, Edwards Lifesciences, Endologix, Hemoteq, Lifetech, Maquet Getinge Group, Medtronic, Mitralign, Nuomao Medtech, Occlutech, PFM Medical, ReCor, Renal Guard, Rox Medical, Terumo, Vascular Dynamics, and Vivasure Medical. Dr Tang has served as a consultant, physician advisory board member, and faculty trainer for Abbott Structural Heart; has served as a consultant for Medtronic and NeoChord; and has served as a physician advisory board member for JenaValve. Dr Andreas has served as a proctor/consultant for and has received speaker fees from Abbott, Edwards LifeSciences, Boston, Zoll and Medtronic; and has received institutional grants from Edwards Lifesciences, Abbott, Medtronic, and LSI Solutions. Dr Gavazzoni has served as a consultant for Abbott Vascular. Dr Braun has received speaker honoraria and travel support from Abbott Vascular. Dr Lubos has received grant support and lecture fees from Abbott; and has received lecture fees from Edwards Lifesciences. Dr Kalbacher has received lecture fees from Abbott and Edwards Lifesciences. Dr Connelly has received honoraria from Abbott. Dr Schofer has served as a consultant for Edwards Lifesciences. Dr Windecker reports research, travel, or educational grants to the institution from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Corflow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medicure, Medtronic, Merck Sharp & Dohme, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pfizer, Polares, Regeneron, Aventis, Servier, Sinomed, Terumo, Vifor, and V-Wave. Dr Windecker serves as an unpaid advisory board member and/or unpaid member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, Janssen, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, V-Wave, and Xeltis, but has not received personal payments by pharmaceutical companies or device manufacturers. He is also a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Maisano has served as a consultant for and received consulting fees and honoraria from Abbott Vascular, Edwards Lifesciences, Cardiovalve, SwissVortex, Perifect, Xeltis, Transseptal Solutions, Magenta, Valtech, and Medtronic; has reported being a cofounder of 4Tech; has received research grant support from Abbott, Medtronic, Edwards Lifesciences, Biotronik, Boston Scientific, NVT, and Terumo; has received royalties and owns intellectual property rights from Edwards Lifesciences (FMR surgical annuloplasty); and has reported being a shareholder in Cardiovalve, Swiss Vortex, Magenta, Transseptal Solutions, Occlufit, 4Tech, and Perifect. Dr Leon has received institutional clinical research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Hahn has served as a consultant for Abbott Vascular, Abbott Structural, NaviGate, Philips Healthcare, Medtronic, Edwards Lifesciences, and GE Healthcare; has been the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-supported trials, for which she receives no direct industry compensation; has received speaker fees from Boston Scientific and Baylis Medical; and has received nonfinancial support from 3mensio. Dr Latib has served on the advisory board for Medtronic, Abbott Vascular Boston Scientific, Edwards Lifesciences, Shifamed, NeoChord Inc, V-dyne, and Philips. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2023. Published by Elsevier Inc.)
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