Reparación de borde a borde de la válvula tricúspide y hospitalizaciones por insuficiencia cardiaca: registro TRI-SPA

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia Pub Date : 2025-02-10 DOI:10.1016/j.recesp.2025.02.002

Julio Echarte-Morales , Laura Sanchis , Dabit Arzamendi , Vanessa Moñivas , Fernando Carrasco-Chinchilla , Manuel Pan , Luis Nombela-Franco , Isaac Pascual , Tomás Benito-González , Ruth Pérez , Iván Gómez-Blázquez , Ignacio J. Amat-Santos , Ignacio Cruz-González , Ángel Sánchez-Recalde , Ana Belén Cid Álvarez , Manuel Barreiro-Pérez , Pedro Cepas-Guillén , Chi Hion Li , María del Trigo , José David Martínez-Carmona , Rodrigo Estévez-Loureiro

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Abstract

Introduction and objectives

The prognostic impact of a history of heart failure hospitalizations (HFH) in patients undergoing transcatheter tricuspid edge-to-edge repair (T-TEER) has been scarcely studied. This study presents the results of the TRI-SPA registry, which includes data from 15 Spanish centers.

Methods

A multicenter, retrospective registry was conducted, including patients who underwent T-TEER between June 2020 and May 2023. Patients were classified into the 3 groups, based on the number of HFH in the 12 months prior to the procedure: no HFH, 1 HFH, and > 1 HFH (recurrent). The primary endpoint was all-cause mortality and HFH.

Results

Of the 262 patients included, 167 (63.7%) had no history of HFH, 60 (22.9%) had 1 HFH, and 35 (13.4%) had > 1 HFH. Patients with > 1 hospitalization had more comorbidities, higher surgical risk, and worse functional class; however, no significant differences were observed in the severity of tricuspid regurgitation either at baseline or after T-TEER. After a median follow-up of 365 [160-643] days, patients with recurrent HFH had higher rates of the composite outcome (9.9%, 16.7%, and 43.1%, respectively; P < .001), as well as higher mortality rates (P = .036) and HFH (P < .001). The number of HFH significantly decreased in the 12 months following T-TEER compared with the 12 months prior (P = .001).

Conclusions

Recurrent HFH within the 12 months prior to the procedure was associated with a higher risk of adverse clinical events during follow-up. T-TEER significantly reduced the number of hospitalizations during the follow-up period.

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三尖瓣边缘修复和心力衰竭住院：TRI-SPA登记

前言和目的在接受经导管三尖瓣边缘到边缘修复（T-TEER）的患者中，心力衰竭住院史（HFH）对预后的影响几乎没有研究。本研究展示了TRI-SPA登记的结果，其中包括来自15个西班牙中心的数据。方法采用多中心回顾性登记方法，纳入2020年6月至2023年5月期间接受T-TEER治疗的患者。根据术前12个月内HFH的发生次数将患者分为3组：无HFH、1次HFH和1次HFH（复发）。主要终点是全因死亡率和HFH。结果262例患者中167例（63.7%）无HFH病史，60例（22.9%）有1次HFH病史，35例（13.4%）有1次HFH病史。住院1次的患者合并症较多，手术风险较高，功能分级较差；然而，无论在基线还是T-TEER后，三尖瓣反流的严重程度都没有观察到显著差异。中位随访365天[160-643]天后，复发HFH患者的复合结局发生率更高（分别为9.9%、16.7%和43.1%,P < 0.001），死亡率（P = 0.036）和HFH （P < 0.001）。与前12个月相比，T-TEER后12个月内HFH数量显著减少（P = .001）。结论手术前12个月内复发的HFH与随访期间不良临床事件的高风险相关。T-TEER在随访期间显著降低了住院次数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista espanola de cardiologia 医学-心血管系统

CiteScore

4.20

自引率

13.60%

发文量

257

审稿时长

28 days

期刊介绍： Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.