Authors
Charlotte Wolff, Paula Sagmeister, Karl Fengler, Karl-Patrik Kresoja, Vera Fortmeier, Wolfgang Rottbauer, Mirjam G Wild, Christoph Pauschinger, Jennifer von Stein, Bjoern Goebel, Paolo Denti, Fabian Voss, Marianna Adamo, Manuel Barreiro-Perez, Mohammad Kassar, Paul Achouh, Tienush Rassaf, Peter Boekstegers, Thorald Stolte, Philipp Schlegel, Antonio Popolo Rubbio, Alessandro Sticchi, Tiffany Patterson, Andreas Rück, Tomás Benito-González, Monika Zdanyte, Martijn Vrijkorte, Giulia Masiero, Flavien Vincent, Stephanie Brunner, Sebastian Rosch, Stefan Toggweiler, Eric Van Belle, Giuseppe Tarantini, Martin Swaans, Tobias Geisler, Enrique Sánchez-Muñóz, Julia Grapsa, Marco De Carlo, Francesco Bedogni, Mathias H Konstandin, Thomas Nestelberger, Nicole Karam, Amir Abbas Mahabadi, Fabien Praz, Rodrigo Estévez-Loureiro, Marco Metra, Amin Polzin, Francesco Maisano, Philipp Lauten, Christos Iliadis, Daniel Kalbacher, Christian Besler, Mirjam Kessler, Volker Rudolph, Philipp Lurz, Jörg Hausleiter, Holger Thiele, Lukas Stolz, Tobias Kister, EuroTR Investigators
Published in
JACC. Advances. Pages 103228. Aug 28, 2026. Epub Aug 28, 2026.
Abstract
In patients undergoing tricuspid valve transcatheter edge-to-edge repair (T-TEER) for tricuspid regurgitation (TR), NYHA functional class guides assessment, but real-world data on its prognostic value and determinants of symptomatic response remain limited.
The objective of the study was to assess the prognostic value of baseline NYHA functional class and identify correlates of NYHA functional class trajectories after T-TEER.
A total of 3,467 patients from the EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation; NCT06307262) undergoing T-TEER were analyzed. Baseline NYHA functional class was related to survival and heart failure hospitalization. In patients with paired NYHA functional class assessments, correlates of improvement and worsening were evaluated using prespecified multivariable logistic regression.
Among 3,424 patients with available baseline NYHA functional class (43 excluded [1.2%]), the median follow-up was 460 days (IQR: 146-856 days). Kaplan-Meier curves demonstrated separation by baseline NYHA functional class for overall and heart failure hospitalization-free survival (both P < 0.001). Two-year mortality was 28.4% (619/3,424; 95% CI: 26.4%-30.4%). In the complete-case Cox cohort (n = 2,185; 63.8%), higher baseline NYHA functional class was associated with 2-year mortality (HR: 1.8 per 1-class increase; 95% CI: 1.5-2.1; P < 0.001). In 1,974 of 3,424 patients (57.7%) with paired NYHA functional class data, NYHA functional classes I/II increased from 16.4% (323/1,974) to 59.4% (1,173/1,974) at follow-up. Improvement was associated with lower body mass index, higher left ventricular ejection fraction, and less residual TR, whereas worsening was associated with lower tricuspid annular plane systolic excursion/systolic pulmonary artery pressure and more residual TR.
In the large real-world EuroTR cohort, baseline NYHA functional class is a strong, independent predictor of 2-year mortality. Symptom trajectories were associated with body mass index, left ventricular ejection fraction, tricuspid annular plane systolic excursion/systolic pulmonary artery pressure, and residual TR.
PMID:
42663375
Bibliographic data and abstract were imported from PubMed on 28 Aug 2026.
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