This study, using data from the EuroTR registry, investigated the impact of prior heart failure hospitalizations (HFHs) on outcomes in patients undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) for symptomatic tricuspid regurgitation (TR). Among 1000 patients analyzed, 63.9% experienced at least one HFH in the year before T-TEER. These patients presented with more advanced heart failure symptoms, worse renal function, and higher natriuretic peptide levels. Despite similar procedural success across all groups—defined as achieving residual TR grade ≤2—the presence of prior HFHs was linked to significantly higher risks of all-cause mortality and combined mortality/HFH outcomes.
Over a median follow-up of 13 months, 30% of patients died and 42% met the composite endpoint of death or HFH. Prior HFH increased the mortality risk by over 50%, while multiple HFHs further elevated the risk of adverse outcomes, especially for the combined endpoint. In contrast, T-TEER was associated with a 72% reduction in HFHs during the year following the procedure, compared to the year before, reinforcing its therapeutic benefit in high-risk patients.
Post-procedural outcomes varied: 41% showed improvement (no HFH post-T-TEER), 39% remained stable, and 20% worsened. The only independent predictor of improved HFH status after T-TEER was achieving residual TR ≤2. These findings underscore the significance of procedural success in modifying disease trajectory.
While limited by its observational design and lack of a control group, the study highlights the critical role of prior HFHs in risk stratification and prognosis for patients undergoing T-TEER. It also supports the therapeutic potential of T-TEER in reducing HFH burden among severely symptomatic TR patients. Future randomized trials with high-risk patient inclusion are essential to confirm these real-world findings and better define the role of T-TEER in heart failure management.
Source: https://onlinelibrary.wiley.com/doi/10.1002/ejhf.3757
