Valvular & structural heart diseaseCohort study
Right Ventricular–Pulmonary Artery Coupling in Tricuspid Regurgitation
- Registry-based cohort study
- propensity matched (1:1)
- European registry
Authors' conclusion
Poorer RVPAC reflects higher baseline risk and mortality, regardless of treatment. T-TEER is associated with better survival across a range of RVPAC values, including those less than previously suggested thresholds.
Study context
- Population
- Patients with tricuspid regurgitation, European registry946 propensity matched
- Participants
- 1,885 patients
- Exposure
- T-TEER vs medical management, by right ventricular-pulmonary artery coupling (RVPAC)
- T-TEERn = 1,300
- Medicaln = 585reference
- Outcome
- Association of RVPAC (TAPSE/systolic pulmonary artery pressure) with mortality
- Follow-up
- 1 year
Main finding
1-year mortality by RVPAC
Hazard ratio
0.11
95% CI 0.04–0.29
P < 0.01
RVPAC vs Medical
HR 0.11 (95% CI 0.04–0.29); P < 0.01
As reported in the abstract
- Mortality differed significantly by RVPAC in both treatment groups
- log-rank P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | Values | HR (95% CI) | P value | |
|---|---|---|---|---|
| Survival, intermediate RVPAC tertile (subgroup) · better survival with T-TEER | 0.54 (0.31–0.94) | P = 0.03 | ||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| TAPSE by RVPAC tertile | <0.32 14 (IQR 12–17) mm · 0.32-0.46 18 (IQR 15–20) mm · >0.46 21 (IQR 18–24) mm | ||
| Systolic pulmonary artery pressure by RVPAC tertile | <0.32 60 (IQR 50–70) mm Hg · 0.32-0.46 45 (IQR 40–52) mm Hg · >0.46 34 (IQR 29–41) mm Hg | ||
| Kidney function by RVPAC tertile | <0.32 43 (IQR 30–57) mL/min/m² · 0.32-0.46 49 (IQR 38–67) mL/min/m² · >0.46 53 (IQR 40–69) mL/min/m² |
- TAPSE by RVPAC tertile: P < 0.01
- Systolic pulmonary artery pressure by RVPAC tertile: P = 0.30
- Kidney function by RVPAC tertile: P = 0.03
Mortality by RVPAC, in each treatment group
- Mortality differed significantly by RVPAC in both treatment groups
- log-rank P < 0.01
Mortality, T-TEER vs medical management, low RVPAC tertile (subgroup)
- Mortality highest in the low RVPAC tertile, no difference between treatment modalities
- HR: 1.04; 95% CI: 0.68-1.61; P = 0.85
Survival, high RVPAC tertile (subgroup)
- Difference persisted but weakened in the high RVPAC tertile, with the overall most favorable outcomes
- HR: 0.69; 95% CI: 0.35-1.36; P = 0.27
Original publication
Right Ventricular–Pulmonary Artery Coupling in Tricuspid Regurgitation. JACC Cardiovasc Interv. Published 9 June 2025. doi:10.1016/j.jcin.2025.04.033
Summarised from the published abstract; every number is checked against it