Quality of life after transcatheter tricuspid valve repair: results from the Tri.FR trial

Aims

In the Tri.FR trial, tricuspid transcatheter edge-to-edge repair (T-TEER) reduced severity of tricuspid regurgitation (TR) and improved the composite clinical score, driven by patient-reported outcomes. The purpose of this study was to describe the longitudinal impact of T-TEER on different dimensions and items of quality of life compared with guideline-directed medical treatment (OMT) alone.

Methods and results

Patients were randomized to T-TEER +OMT (n = 152) or OMT alone (n = 148). Health status was assessed at baseline, 6 weeks, 6 months, and 1 year using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Minnesota Living with Heart Failure (MLHF) Questionnaire. Mixed effects linear regression analysed changes over time. Patients receiving T-TEER + OMT experienced a significant increase in KCCQ overall summary score (KCCQ-OS) at all time points: +17.0 points (95% confidence interval [CI] 13.1–21.5) at 6 weeks, +15.9 points (95% CI 11.2–20.6) at 6 months, and +18.7 points (95% CI 13.8–23.6) at 1 year. The mean between-group difference in KCCQ-OS was +10.3 points (95% CI 5.6–15.0) in favour of T-TEER + OMT, evident at 6 weeks and sustained for 1 year. Similarly, MLHF total scores improved significantly in the T-TEER group (mean between-group difference −8.61 points, 95% CI –12.6 to −4.6), including physical (−3.9, 95% CI –5.9 to −1.9) and emotional (−2.2, 95% CI –3.4 to −1.0) subscales.

Conclusions

Compared with OMT alone, T-TEER resulted in substantial, multidimensional, and sustained improvements in patient-reported quality of life. These findings reinforce the value of T-TEER in managing severe symptomatic TR.