Francesco Stabile, Sebastian Jaramillo, Bezalel Hakkeem, Cristina Madaudo, Giuseppe Vadalà, Daniela Di Lisi, Vincenzo Sucato, Egle Corrado, Giuseppina Novo, Kalgi Modi, Alfredo Ruggero Galassi
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Heterogeneity was assessed with I2 statistics, and a random-effects model was used for all the outcomes.</p><p><strong>Results: </strong>We included two RCTs and four observational studies with a total of 1805 patients, of whom 849 (47%) underwent T-TEER plus OMT. We found a trend favoring T-TEER for all-cause mortality [risk ratio 0.87; 95% confidence interval (95% CI) 0.66-1.13; P = 0.30] and cardiovascular death (risk ratio 0.77; 95% CI 0.36-1.65; P = 0.50), although without statistically significant difference. Heart failure hospitalizations (risk ratio 0.72; 95% CI 0.61-0.85; P = 0.0001) were significantly reduced in patients treated with T-TEER compared with OMT alone. Tricuspid regurgitation severity 2+ or less was also more frequently achieved in the T-TEER group (risk ratio 6.42; 95% CI 3.08-13.39; P < 0.001). Functional status and quality of life were significantly improved, with higher KCCQ scores [(mean difference) +14.01], longer 6MWT distance (MD +29.35 m), and a greater proportion of patients in NYHA class I-II (risk ratio 1.39; 95% CI 1.27-1.51; P < 0.00001).</p><p><strong>Conclusion: </strong>In patients with severe symptomatic TR, T-TEER is associated with significant improvements in tricuspid regurgitation severity, reduction in heart failure hospitalizations, and enhanced quality of life and functional status, with no apparent effect on all-cause mortality and cardiovascular death.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"519-526"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tricuspid transcatheter edge-to-edge repair for severe symptomatic tricuspid regurgitation: a systematic review and meta-analysis.\",\"authors\":\"Francesco Stabile, Sebastian Jaramillo, Bezalel Hakkeem, Cristina Madaudo, Giuseppe Vadalà, Daniela Di Lisi, Vincenzo Sucato, Egle Corrado, Giuseppina Novo, Kalgi Modi, Alfredo Ruggero Galassi\",\"doi\":\"10.2459/JCM.0000000000001770\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Severe tricuspid regurgitation is associated with elevated morbidity and mortality. In recent years, tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a promising procedure for the treatment of this valvular disease. We conducted a systematic review and meta-analysis to compare the effectiveness of T-TEER with optimized medical therapy (OMT) versus OMT alone for the treatment of severe tricuspid regurgitation.</p><p><strong>Methods: </strong>PubMed, Scopus, and Cochrane databases were searched for randomized controlled trials (RCTs) and observational studies comparing T-TEER plus OMT vs. OMT alone. Heterogeneity was assessed with I2 statistics, and a random-effects model was used for all the outcomes.</p><p><strong>Results: </strong>We included two RCTs and four observational studies with a total of 1805 patients, of whom 849 (47%) underwent T-TEER plus OMT. 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引用次数: 0
摘要
背景：严重的三尖瓣反流与高发病率和死亡率相关。近年来，三尖瓣经导管边缘到边缘修复（T-TEER）已成为治疗这种瓣膜疾病的一种很有前途的方法。我们进行了一项系统回顾和荟萃分析，比较T-TEER联合优化药物治疗（OMT）与单独使用OMT治疗严重三尖瓣反流的有效性。方法：检索PubMed、Scopus和Cochrane数据库，比较T-TEER联合OMT与单独OMT的随机对照试验（rct）和观察性研究。采用I2统计量评估异质性，所有结果均采用随机效应模型。结果：我们纳入了2项随机对照试验和4项观察性研究，共1805例患者，其中849例（47%）接受了T-TEER + OMT治疗。我们发现全因死亡率倾向于T-TEER[风险比0.87；95%置信区间（95% CI） 0.66-1.13；P = 0.30]和心血管死亡(危险比0.77；95% ci 0.36-1.65；P = 0.50)，但差异无统计学意义。心力衰竭住院(风险比0.72；95% ci 0.61-0.85；P = 0.0001)，接受T-TEER治疗的患者与单独接受OMT治疗的患者相比显著降低。T-TEER组三尖瓣返流严重程度2+或更低的发生率也更高(风险比6.42；95% ci 3.08-13.39；结论：在严重症状性TR患者中，T-TEER可显著改善三尖瓣反流严重程度、降低心力衰竭住院率、提高生活质量和功能状态，但对全因死亡率和心血管死亡无明显影响。
Tricuspid transcatheter edge-to-edge repair for severe symptomatic tricuspid regurgitation: a systematic review and meta-analysis.
Background: Severe tricuspid regurgitation is associated with elevated morbidity and mortality. In recent years, tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a promising procedure for the treatment of this valvular disease. We conducted a systematic review and meta-analysis to compare the effectiveness of T-TEER with optimized medical therapy (OMT) versus OMT alone for the treatment of severe tricuspid regurgitation.
Methods: PubMed, Scopus, and Cochrane databases were searched for randomized controlled trials (RCTs) and observational studies comparing T-TEER plus OMT vs. OMT alone. Heterogeneity was assessed with I2 statistics, and a random-effects model was used for all the outcomes.
Results: We included two RCTs and four observational studies with a total of 1805 patients, of whom 849 (47%) underwent T-TEER plus OMT. We found a trend favoring T-TEER for all-cause mortality [risk ratio 0.87; 95% confidence interval (95% CI) 0.66-1.13; P = 0.30] and cardiovascular death (risk ratio 0.77; 95% CI 0.36-1.65; P = 0.50), although without statistically significant difference. Heart failure hospitalizations (risk ratio 0.72; 95% CI 0.61-0.85; P = 0.0001) were significantly reduced in patients treated with T-TEER compared with OMT alone. Tricuspid regurgitation severity 2+ or less was also more frequently achieved in the T-TEER group (risk ratio 6.42; 95% CI 3.08-13.39; P < 0.001). Functional status and quality of life were significantly improved, with higher KCCQ scores [(mean difference) +14.01], longer 6MWT distance (MD +29.35 m), and a greater proportion of patients in NYHA class I-II (risk ratio 1.39; 95% CI 1.27-1.51; P < 0.00001).
Conclusion: In patients with severe symptomatic TR, T-TEER is associated with significant improvements in tricuspid regurgitation severity, reduction in heart failure hospitalizations, and enhanced quality of life and functional status, with no apparent effect on all-cause mortality and cardiovascular death.
期刊介绍：
Journal of Cardiovascular Medicine is a monthly publication of the Italian Federation of Cardiology. It publishes original research articles, epidemiological studies, new methodological clinical approaches, case reports, design and goals of clinical trials, review articles, points of view, editorials and Images in cardiovascular medicine.
Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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