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. 2025 Jul 18.
doi: 10.1002/ejhf.3757. Online ahead of print.

Heart failure hospitalizations and clinical outcomes in patients undergoing tricuspid transcatheter edge-to-edge repair: Insights from EuroTR

Daniela Tomasoni  1   2 , Marianna Adamo  1 , Jörg Hausleiter  3   4 , Elisa Pezzola  1 , Karl-Patrik Kresoja  5 , Jennifer von Stein  6 , Vera Fortmeier  7 , Christoph Pauschinger  8   9 , Wolfgang Rottbauer  10 , Mohammad Kassar  11 , Bjoern Goebel  12 , Paolo Denti  13 , Paul Achouh  14 , Tienush Rassaf  15 , Manuel Barreiro-Perez  16 , Peter Boekstegers  17 , Andreas Rück  18 , Monika Zdanyte  19 , Flavien Vincent  20 , Philipp Schlegel  21 , Ralph-Stephan von Bardeleben  5 , Mirjam G Wild  22 , Christian Besler  22 , Stephanie Brunner  23 , Stefan Toggweiler  23 , Julia Grapsa  24 , Tiffany Patterson  24 , Holger Thiele  25 , Tobias Kister  25 , Giuseppe Tarantini  26 , Giulia Masiero  26 , Marco De Carlo  27 , Alessandro Sticchi  27 , Mathias H Konstandin  21 , Eric Van Belle  20 , Tobias Geisler  19 , Rodrigo Estévez-Loureiro  16 , Peter Luedike  15 , Nicole Karam  14 , Francesco Maisano  13 , Philipp Lauten  12 , Fabien Praz  11 , Mirjam Kessler  10 , Daniel Kalbacher  8   9 , Volker Rudolph  7 , Christos Iliadis  6 , Philipp Lurz  5 , Lukas Stolz  3 , Marco Metra  1 ; EuroTR Investigators
Collaborators, Affiliations
Free article

Heart failure hospitalizations and clinical outcomes in patients undergoing tricuspid transcatheter edge-to-edge repair: Insights from EuroTR

Daniela Tomasoni et al. Eur J Heart Fail. .
Free article

Abstract

Aims: To assess the prevalence, prognostic significance, and predictors of heart failure hospitalization (HFH) before and after tricuspid transcatheter edge-to-edge repair (T-TEER) in a large real-world cohort of patients with tricuspid regurgitation (TR).

Methods and results: Data from the European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR registry) were analysed. Among 1000 patients undergoing T-TEER for symptomatic TR, 361 (36.1%) had no HFH, 459 (45.9%) had one single HFH, and 180 (18.0%) had multiple HFH the year before T-TEER. Patients with any HFH had more severe heart failure compared with those without. Procedural success (residual TR ≤2) did not differ between patients with single, multiple, or no HFHs before T-TEER. Multivariable analysis showed that a history of HFH was associated with an increased mortality risk (adjusted hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.11-2.06 for single vs. no HFH; adjusted HR 1.63, 95% CI 1.15-2.31 for multiple vs. no HFH), and a higher risk of the combined endpoint of all-cause mortality or HFH. HFH risk decreased by 72% in the 1 year following T-TEER compared to the previous year. Procedural success was the sole independent predictor for reducing HFHs.

Conclusions: In the EuroTR cohort, a history of HFH was highly prevalent and associated with worse clinical outcomes. Among high-risk patients with symptomatic TR, T-TEER significantly lowered HFH risk, with residual TR grade ≤2 being the key predictor for reduced HFH incidence.

Keywords: Heart failure hospitalization; Mortality; Transcatheter edge‐to‐edge repair; Tricuspid regurgitation; T‐TEER.

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