Trikuspidalklappeninsuffizienz – Optimierung der Ergebnisse durch individualisierte Therapie DOI
Thomas Stocker, Lukas Stolz,

Jörg Hausleiter

et al.

Aktuelle Kardiologie, Journal Year: 2025, Volume and Issue: 14(01), P. 61 - 66

Published: Feb. 1, 2025

Zusammenfassung Die hochgradige Trikuspidalklappeninsuffizienz ist eine schwerwiegende Erkrankung und mit einer ungünstigen Prognose vergesellschaftet. Mit der Entwicklung neuer interventioneller Therapieoptionen nimmt die innerhalb Kardiologie einen zunehmenden Stellenwert ein. Das heterogene Erscheinungsbild das Auftreten im Kontext unterschiedlicher Begleiterkrankungen bedürfen detaillierten diagnostischen Aufarbeitung. Dabei sollte in einem möglichst frühen Stadium Rechtsherzinsuffizienz identifiziert weiterführend abgeklärt werden, um durch rechtzeitige Therapie mögliche Endorganschäden zu verhindern. Nach interdisziplinärer Falldiskussion Abwägung aller medikamentösen, chirurgischen interventionellen Optionen findet individualisierte anschließende strukturierte Nachverfolgung Patienten Herzklappenzentrum statt. Nachdem Behandlungserfolg von Erfahrung des Herzklappenzentrums abhängig ist, sollten Eingriffe vorrangig hochvolumigen Zentren hoher Expertise durchgeführt werden. Nur so kann nach wie vor hohen Morbidität Letalität begegnet

Transcatheter Valve Replacement in Severe Tricuspid Regurgitation DOI
Rebecca T. Hahn,

Raj Makkar,

Vinod H. Thourani

et al.

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 30, 2024

BackgroundSevere tricuspid regurgitation is associated with disabling symptoms and an increased risk of death. Data regarding outcomes after percutaneous transcatheter tricuspid-valve replacement are needed.MethodsIn this international, multicenter trial, we randomly assigned 400 patients severe symptomatic in a 2:1 ratio to undergo either medical therapy (valve-replacement group) or alone (control group). The hierarchical composite primary outcome was death from any cause, implantation right ventricular assist device heart transplantation, postindex intervention, hospitalization for failure, improvement at least 10 points the score on Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ-OS), one New York Heart Association (NYHA) functional class, 30 m 6-minute walk distance. A win calculated by comparing all possible patient pairs, starting first event hierarchy.ResultsA total 267 were valve-replacement group 133 control group. At 1 year, favoring valve 2.02 (95% confidence interval [CI], 1.56 2.62; P<0.001). In comparisons those had more wins than respect cause (14.8% vs. 12.5%), intervention (3.2% 0.6%), KCCQ-OS (23.1% 6.0%), NYHA class (10.2% 0.8%), distance (1.1% 0.9%). fewer annualized rate failure (9.7% 10.0%). Severe bleeding occurred 15.4% 5.3% (P=0.003); new permanent pacemakers implanted 17.4% 2.3%, respectively (P<0.001).ConclusionsFor regurgitation, superior outcome, driven primarily improvements quality life. (Funded Edwards Lifesciences; TRISCEND II ClinicalTrials.gov number, NCT04482062.)

Language: Английский

Citations

37
Prognostic Implications of Residual Tricuspid Regurgitation Grading After Transcatheter Tricuspid Valve Repair DOI
Julien Dreyfus, Maurizio Taramasso, Karl‐Patrik Kresoja

et al.

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2024, Volume and Issue: 17(12), P. 1485 - 1495

Published: May 16, 2024

Language: Английский

Citations

22
Tricuspid Regurgitation in Patients With Heart Failure and Preserved Ejection Fraction DOI
Rebecca T. Hahn,

JoAnn Lindenfeld,

Michael Böhm

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(2), P. 195 - 212

Published: July 1, 2024

Language: Английский

Citations

18
Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the Heart Failure Association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC DOI Creative Commons
Marianna Adamo,

Ovidiu Chioncel,

Matteo Pagnesi

et al.

European Journal of Heart Failure, Journal Year: 2023, Volume and Issue: 26(1), P. 18 - 33

Published: Dec. 22, 2023

Right‐sided heart failure and tricuspid regurgitation are common strongly associated with poor quality of life an increased risk hospitalizations death. While medical therapy for right‐sided is limited, treatment options include surgery and, based on recent developments, several transcatheter interventions. However, the patients who might benefit from valve interventions yet unknown, as ideal time these treatments given paucity clinical evidence. In this context, it crucial to elucidate aetiology pathophysiological mechanisms leading in order recognize when a mere bystander can cause or contribute progression. Notably, early identification right may be optimal management requires knowledge about different causes, course presentation, well possible options. The aim consensus statement summarize current epidemiology, pathophysiology providing practical suggestions patient management.

Language: Английский

Citations

24
GLIDE Score DOI Creative Commons
Muhammed Gerçek, Akhil Narang, Maria Isabel Körber

et al.

JACC. Cardiovascular imaging, Journal Year: 2024, Volume and Issue: 17(7), P. 729 - 742

Published: June 5, 2024

Tricuspid valve transcatheter edge-to-edge repair (T-TEER) is the most widely used therapy to treat patients with tricuspid regurgitation (TR). The aim of this study was develop a simple anatomical score predict procedural outcomes T-TEER. All (n = 168) who underwent T-TEER between January 2017 and November 2022 at 2 centers were included in derivation cohort. Additionally, 126 from separate institutions served as validation performed using commercially available technologies. Core laboratory assessment transesophageal echocardiograms determine septolateral anteroposterior coaptation gap, leaflet morphology, septal length retraction, chordal structure density, tethering height, en face TR jet morphology location, image quality, presence intracardiac leads. A scoring system derived univariable multivariable logistic regression. Endpoints assessed immediate postprocedural reduction ≥2 grades grade moderate or less. median age 82 years (Q1-Q3: 78-84 years); 48% women; presented severe (55%), massive (36%), torrential (8%) TR. Five variables (septolateral quality) identified best predicting outcome incorporated GLIDE (Gap, Location, Image en-face morphology) (range 0-5). less observed >90% scores 0 1 only 5.6% 16.7% those ≥4. then externally validated cohort (area under curve: 0.77; 95% CI: 0.69-0.86). significantly correlated functional improvement by NYHA class 6-minute walk distance 3 months. simple, 5-component that readily obtained during patient imaging can successful

Language: Английский

Citations

15
New Approaches to Assessment and Management of Tricuspid Regurgitation Before Intervention DOI
Garrett A. Welle, Rebecca T. Hahn, JoAnn Lindenfeld

et al.

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2024, Volume and Issue: 17(7), P. 837 - 858

Published: April 1, 2024

Language: Английский

Citations

12
Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left‐sided valvular heart disease in Europe. Insights from the ESC‐EORP Valvular Heart Disease II survey DOI Open Access
Julien Dreyfus, Monika Komar, David Attias

et al.

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(4), P. 994 - 1003

Published: Feb. 19, 2024

Language: Английский

Citations

10
Right Heart Remodeling and Outcomes in Patients With Tricuspid Regurgitation DOI Creative Commons
Sara Bombace, Federico Fortuni, Giacomo Viggiani

et al.

JACC. Cardiovascular imaging, Journal Year: 2024, Volume and Issue: 17(6), P. 595 - 606

Published: Feb. 28, 2024

Functional tricuspid regurgitation (TR) can develop either because of right ventricular (RV) remodeling (ventricular functional TR) and/or atrial dilation (atrial TR). This meta-analysis aimed to investigate the association between heart and long-term (>1 year) all-cause mortality in patients with significant TR (at least moderate, ≥2+). MEDLINE, ISI Web Science, SCOPUS databases were searched. Studies reporting data on at 1 RV parameter included. study was designed according PRISMA (Preferred Reporting Items for Systematic Reviews Meta-Analyses) requirements. Out 8,902 studies, a total 14 included, enrolling 4,394 subjects. The duration follow-up across studies varied, ranging from minimum 15.5 months maximum 73.2 months. Overall, 31% (95% CI: 20%-41%; P ≤ 0.001). By means meta-regression analyses, an inverse relation found annular plane systolic excursion (11 3,551 subjects, −6.3% [95% −11.1% −1.4%]; = 0.011), fractional area change (9 2,975 −4.4% −5.9% −2.9%]; < 0.001), dimension (7 2,986 −4.1% −7.6% −0.5%]; 0.026), (6 1,920 −1.9% −2.5% −1.3%]; 0.001) mortality. dysfunction parameters are associated worse clinical outcomes TR, whereas dilatation is linked better prognostic outcome. Further needed unravel pathophysiological differences within spectrum. (Right regurgitation; CRD42023418667)

Language: Английский

Citations

10
Transjugular Transcatheter Tricuspid Valve Replacement DOI Creative Commons
Lukas Stolz,

Anson Cheung,

Robert Boone

et al.

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2024, Volume and Issue: 17(16), P. 1936 - 1945

Published: Aug. 1, 2024

Data on procedural and early outcomes after transjugular transcatheter tricuspid valve replacement (TTVR) are limited.

Language: Английский

Citations

10
EVOQUE Tricuspid Valve Replacement System DOI
Rebecca T. Hahn,

Raj Makkar,

Moody Makar

et al.

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2024, Volume and Issue: 17(18), P. 2093 - 2112

Published: Sept. 1, 2024

Language: Английский

Citations

10