Skip to main content

ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Heart Valve Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1452446

Effective tricuspid regurgitation reduction is associated with renal improvement and reduced heart failure hospitalization

Provisionally accepted
Dominik Felbel Dominik Felbel Juliana von Winkler Juliana von Winkler Michael Paukovitsch Michael Paukovitsch Matthias Gröger Matthias Gröger Elene Walther Elene Walther Stefanie Andreß Stefanie Andreß Leonhard Schneider Leonhard Schneider Sinisa Markovic Sinisa Markovic Wolfgang Rottbauer Wolfgang Rottbauer Mirjam Keßler Mirjam Keßler *
  • Ulm University Heart Center, Ulm, Germany

The final, formatted version of the article will be published soon.

    Background: Several studies have demonstrated an association between tricuspid regurgitation (TR) and organ dysfunction including hepatic and renal insufficiency. Improvement of liver function following transcatheter edge-to-edge repair (T-TEER) has already been linked to reduction of venous congestion due to TR reduction. This study analyzes whether TR-reduction using T-TEER is also associated with improved renal function. Methods and results: The TRIC-ULM registry includes 92 selected patients undergoing T-TEER between March 2017 and May 2023. Estimated glomerular filtration rate (eGFR) improvement was evident in 53 patients (57%) at 3-months follow-up (FU) and defined by FU eGFR > baseline eGFR. Median age was 80 [interquartile range 75 - 83] years, pre- and postinterventional TR grades were 4 [3-5] and 1 [1-2], baseline eGFR was 36 [30 - 53] ml/min and New Yeark Heart Association (NYHA) IV was evident in 15% of patients. Multiple logistic regression analysis revealed TR vena contracta reduction (Odds ratio (OR) 1.35 [95%-CI 1.12 – 1.64] per mm, p=0.002) and reduced preinterventional tricuspid annular plane systolic excursion (TAPSE) (OR 0.89 [95%-CI 0.79 – 0.99] per mm, p=0.033) to independently predict renal improvement at FU. An eGFR improvement threshold of >9 ml/min was associated with reduced 1-year heart failure hospitalization rates (adjusted hazard ratio 0.22 [95%-CI 0.07 – 0.62] p=0.005). Conclusion: Effective tricuspid edge-to-edge repair is associated with improved renal function and reduced heart failure hospitalization. In patients without renal improvement at 3-months follow-up, residual tricuspid regurgitation should be reevaluated for reintervention.

    Keywords: Tricuspid regurgitation, Renal improvement, Heart failure hospitalization, Edge-to-edge repair, T-TEER

    Received: 20 Jun 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Felbel, von Winkler, Paukovitsch, Gröger, Walther, Andreß, Schneider, Markovic, Rottbauer and Keßler. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mirjam Keßler, Ulm University Heart Center, Ulm, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.