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Valvular & structural heart diseaseCohort study

Prognostic Value of NYHA Functional Class in Tricuspid Valve Transcatheter Edge-to-Edge Repair

JACC AdvPublished

  • registry
  • real-world
  • prespecified multivariable logistic regression
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Authors' conclusion

In the large real-world EuroTR cohort, baseline NYHA functional class is a strong, independent predictor of 2-year mortality. Symptom trajectories were associated with body mass index, left ventricular ejection fraction, tricuspid annular plane systolic excursion/systolic pulmonary artery pressure, and residual TR.

Study context

Population
Patients undergoing tricuspid valve transcatheter edge-to-edge repair (T-TEER) for tricuspid regurgitation (TR) in the EuroTR registrypatients analyzed, 3,424 with available baseline NYHA functional class (43 excluded [1.2%])
Participants
3,467 patients
Exposure
Baseline NYHA functional class related to survival and heart failure hospitalization

Main finding

As reported in the abstract

Overall and heart failure hospitalization-free survival by baseline NYHA functional class

Kaplan-Meier curves demonstrated separation by baseline NYHA functional class

both P < 0.001

Observational data: associations, not effects.

Further findings

OutcomeHR (95% CI)P value
2-year mortality by baseline NYHA functional class · complete-case Cox cohort (n = 2,185; 63.8%)1.8 (1.5–2.1)P < 0.001
  • 2-year mortality by baseline NYHA functional class: complete-case Cox cohort (n = 2,185; 63.8%)

Two-year mortality · 2 years

Two-year mortality
28.4% (619/3,424; 95% CI: 26.4%-30.4%)

Follow-up

median follow-up
460 days (IQR: 146-856 days)

NYHA functional classes I/II in patients with paired NYHA data · follow-up

patients with paired NYHA functional class data
1,974 of 3,424 patients (57.7%)
NYHA functional classes I/II at baseline
16.4% (323/1,974)
NYHA functional classes I/II at follow-up
59.4% (1,173/1,974)

Correlates of NYHA improvement and worsening

Improvement was associated with lower body mass index, higher left ventricular ejection fraction, and less residual TR
worsening was associated with lower tricuspid annular plane systolic excursion/systolic pulmonary artery pressure and more residual TR

Original publication

Prognostic Value of NYHA Functional Class in Tricuspid Valve Transcatheter Edge-to-Edge Repair. JACC Adv. Published 28 August 2026. doi:10.1016/j.jacadv.2026.103228
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Summarised from the published abstract; every number is checked against it