Valvular & structural heart diseaseCohort study
Left atrial remodelling and diastolic unloading after transcatheter tricuspid repair
- consecutive patients undergoing transcatheter tricuspid edge-to-edge repair (T-TEER) within the TRI-FR trial and registry
- linear mixed-effects models
- echocardiography at baseline, pre-discharge, and at 6 and 12 months
Authors' conclusion
Transcatheter tricuspid edge-to-edge repair induces immediate anatomical LA unloading but does not restore LA mechanical function. Despite early reductions in LA volume, filling pressure surrogates increased, LA stiffness remained elevated, and forward flow did not improve. These findings demonstrate a dissociation between structural and functional remodelling after TR correction and highlight the importance of serial assessment of LA mechanics and diastolic physiology following T-TEER.
Study context
- Population
- Consecutive patients with tricuspid regurgitation undergoing transcatheter tricuspid edge-to-edge repair (T-TEER) within the TRI-FR trial and registryconsecutive patients undergoing T-TEER
- Participants
- 125 patients
- Exposure
- Longitudinal changes after T-TEER vs baseline
- T-TEERn = 125
Main finding
As reported in the abstract
estimated change
−8.1 ml/m²; 95% CI −14.6 to −1.6; adjusted P = .033
Observational data: associations, not effects.
Further findings
Peak atrial longitudinal strain (PALS) · throughout follow-up
- PALS
- −1.2%; 95% confidence interval (CI) −2.0 to −0.3; adjusted P = .029
- Left atrial (LA) reservoir function deteriorated early and remained impaired
E/e′ (estimated LV filling pressure) · acutely
- E/e′
- + 3.26; 95% CI 2.34-4.18; adjusted P < .001
LA stiffness index (LASI) · 12 months
- ratio
- 1.22; 95% CI 1.05-1.42; adjusted P = .016
Stroke volume index and cardiac index · over time
- Stroke volume index, no significant change
- P = 0.969
- Cardiac index, no significant change
- P = 0.562
Safety
Early mitral regurgitation worsening
- patients with early MR worsening
- 20%
- transient and unrelated to changes in diastolic or forward-flow parameters
Original publication
Summarised from the published abstract; every number is checked against it