{"id":"44651b83f9f9","type":"article","url":"https://hartvaat.nl/2026/05/05/eurotr-register-co-existente-linkszijdige-kleplek-verhoogt-sterfte-na-transcathe/","title":"EuroTR-register: co-existente linkszijdige kleplek verhoogt sterfte na transcatheter-tricuspidalis-edge-to-edge repair","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["esc-2026","mitraclip","tricuspidalisinsufficiëntie"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag103","source_url":"https://doi.org/10.1093/eschf/xvag103","authors":["Jonas Gmeiner","Lukas Stolz","Karl-Patrik Kresoja","Jennifer von Stein","Vera Fortmeier","Christoph Pauschinger","Wolfgang Rottbauer","Mohammad Kassar","Bjoern Goebel","Paolo Denti","Paul Achouh","Tienush Rassaf","Manuel Barreiro-Perez","Peter Boekstegers","Andreas Rück","Monika Zdanyte","Marianna Adamo","Flavien Vincent","Philipp Schlegel","Sebastian Rosch","Mirjam G Wild","Christian Besler","Stefan Toggweiler","Stephanie Brunner","Julia Grapsa","Tiffany Patterson","Holger Thiele","Tobias Kister","Giuseppe Tarantini","Giulia Masiero","Marco De Carlo","Alessandro Sticchi","Fabian Voss","Amin Polzin","Antonio Popolo Rubbio","Francesco Bedogni","Thorald Stolte","Thomas Nestelberger","Thomas Benito-Gonzales","Enrique Sánchez-Muñóz","Mathias H Konstandin","Eric Van Belle","Marco Metra","Tobias Geisler","Rodrigo Estévez-Loureiro","Amir Abbas Mahabadi","Nicole Karam","Francesco Maisano","Philipp Lauten","Fabien Praz","Mirjam Kessler","Daniel Kalbacher","Volker Rudolph","Christos Iliadis","Philipp Lurz","Jörg Hausleiter"],"significance":7,"published":"2026-06-27","source_date":"2026-05-05","image":"","kennis":[],"congress":"esc-2026","summary_en":"Analysis of the European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR) in 1,647 patients undergoing T-TEER. Concomitant left-sided valve disease (VHD) ≥mild was present in 95.8%, ≥moderate in 35.6%, and severe in 3.8%. ≥moderate VHD was associated with significantly lower 2-year survival (p<0.001) and HF-hospitalisation-free survival (p=0.005). Multivariable analysis confirmed ≥moderate VHD as an independent mortality predictor (HR 1.54; 95% CI 1.21-1.96; p<0.001). Despite worse baseline TR and NYHA in patients with ≥moderate VHD, T-TEER delivered significant TR reduction and symptomatic improvement in both groups. Conclusion: left-sided valvular disease should be weighed in the prognosis of T-TEER candidates, while symptomatic benefit is generally preserved.","created":"2026-07-03T10:33:07Z","updated":"2026-08-10T11:07:51Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse van het European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR) bij 1.647 patiënten die T-TEER ondergingen voor tricuspidalisinsufficiëntie. Linkszijdige klepafwijking (VHD) van ≥mild kwam voor bij 95,8%, ≥matig bij 35,6% en ernstig bij 3,8%. ≥matige VHD was geassocieerd met significant lagere 2-jaars overleving (p<0,001) en lagere HF-opname-vrije overleving (p=0,005). Multivariate analyse bevestigde ≥matige VHD als onafhankelijke voorspeller van mortaliteit (HR 1,54; 95%-BI 1,21-1,96; p<0,001). Ondanks slechtere baseline-TR en NYHA bij ≥matige VHD bracht T-TEER bij beide groepen significante TR-reductie en symptomatische verbetering. Conclusie: bij T-TEER moet linkszijdige kleplekkage worden meegewogen voor prognose, terwijl symptomatische winst meestal behouden blijft.","abstract_original":"INTRODUCTION: The impact of coexisting left-sided valvular heart disease (VHD) on clinical outcomes following tricuspid valve edge-to-edge repair (T-TEER) for tricuspid regurgitation (TR) remains unclear, particularly under real-world conditions. To evaluate the prevalence and prognostic impact of concomitant left-sided VHD in patients undergoing T-TEER. METHODS: This study included all patients undergoing T-TEER from the European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR; NCT06307262) with complete echocardiographic data on left-sided valve disease. Study endpoints included survival and heart failure hospitalizations (HFH) at 2 years, NYHA functional class, and TR reduction. RESULTS: Among a total of 1647 eligible patients, 95.8%, 35.6%, and 3.8% had ≥mild, moderate, and severe concomitant VHD, respectively. Moderate or higher VHD was associated with a significantly reduced 2-year survival (P < .001) and reduced 2-year HFH-free survival (P = .005). Multivariate regression analysis confirmed ≥ moderate VHD to be an independent predictor of mortality (hazard ratio 1.54, 95% CI 1.21-1.96, P < .001). Despite worse TR and NYHA functional class at baseline in patients with ≥moderate VHD, T-TEER was associated with a significant TR reduction (P < .001) and symptomatic improvement (P < .001). CONCLUSION: Concomitant left-sided VHD is common among patients undergoing T-TEER and is independently associated with worse survival and higher rates of HFH. Nevertheless, T-TEER provides meaningful symptomatic benefit and durable TR reduction in patients with and without VHD burden."}