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Multicenter Study
. 2025 Jul;27(7):1304-1314.
doi: 10.1002/ejhf.3623. Epub 2025 Feb 20.

Malnutrition and outcomes in patients with tricuspid regurgitation undergoing transcatheter tricuspid valve repair

Matteo Pagnesi #  1 , Marianna Adamo #  1 , Lukas Stolz  2   3 , Edoardo Pancaldi  1 , Karl-Patrik Kresoja  4 , Jennifer von Stein  5 , Vera Fortmeier  6 , Benedikt Koell  7   8 , Wolfgang Rottbauer  9 , Mohammad Kassar  10 , Bjoern Goebel  11 , Paolo Denti  12 , Paul Achouh  13 , Tienush Rassaf  14 , Manuel Barreiro-Perez  15 , Peter Boekstegers  16 , Andreas Rück  17 , Monika Zdanyte  18 , Flavien Vincent  19 , Philipp Schlegel  20 , Ralph-Stephan von Bardeleben  4 , Mirjam G Wild  21 , Christian Besler  21 , Stephanie Brunner  22 , Stefan Toggweiler  22 , Julia Grapsa  23 , Tiffany Patterson  23 , Holger Thiele  24 , Tobias Kister  24 , Giuseppe Tarantini  25 , Giulia Masiero  25 , Marco De Carlo  26 , Alessandro Sticchi  26 , Mathias H Konstandin  20 , Eric Van Belle  19 , Tobias Geisler  18 , Rodrigo Estévez-Loureiro  15 , Peter Luedike  14 , Nicole Karam  13 , Francesco Maisano  12 , Philipp Lauten  11 , Fabien Praz  10 , Mirjam Kessler  9 , Daniel Kalbacher  7   8 , Volker Rudolph  6 , Christos Iliadis  5 , Philipp Lurz  4 , Jörg Hausleiter #  2   3 , Marco Metra #  1 ; on behalf of the EuroTR Investigators
Collaborators, Affiliations
Multicenter Study

Malnutrition and outcomes in patients with tricuspid regurgitation undergoing transcatheter tricuspid valve repair

Matteo Pagnesi et al. Eur J Heart Fail. 2025 Jul.

Abstract

Aims: The impact of malnutrition in patients with tricuspid regurgitation (TR) undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) is not well established. We evaluated the impact of malnutrition among patients with symptomatic TR undergoing T-TEER.

Methods and results: Baseline nutritional status was evaluated using the geriatric nutritional risk index (GNRI), based on serum albumin concentrations and body weight to ideal body weight ratio, among patients with symptomatic TR undergoing T-TEER, enrolled in the multicentre EuroTR registry between March 2016 and February 2024. Malnutrition was defined as GNRI ≤98. The primary outcome of interest was all-cause mortality. A total of 1034 patients were included (mean age 78.4 ± 7.3 years, 47.7% male). Among them, GNRI ≤98 (i.e. malnutrition) was observed in 211 patients (20.4%). Estimated rates of all-cause death at 2 years were 45.9% and 28.2% in patients with and without malnutrition, respectively (log-rank p < 0.001). After multivariable adjustment, malnutrition was independently associated with an increased risk of mortality (adjusted hazard ratio 1.53, 95% confidence interval 1.11-2.10, p = 0.009), also confirmed at inverse probability of treatment weighting-adjusted analysis. As compared to post-procedural residual TR ≥3+, residual TR ≤2+ was associated with a similar lower risk of mortality in patients with and without malnutrition (interaction p = 0.947).

Conclusion: In the large, real-world, multicentre EuroTR registry, malnutrition was present in one out of five patients with symptomatic TR undergoing T-TEER and was independently associated with increased mortality. The prognostic benefit of successful T-TEER in reducing mortality was consistently observed in patients with and without malnutrition.

Keywords: Clinical outcomes; Geriatric nutritional risk index; Heart failure; Malnutrition; Tricuspid regurgitation; Tricuspid transcatheter edge‐to‐edge repair.

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References

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