TRI-SCORE is superior to EuroSCORE II and STS-Score in mortality prediction following transcatheter edge-to-edge tricuspid valve repair.
EuroSCORE II
STS-Score
TRI-SCORE
Tricuspid regurgitation
Tricuspid valve repair
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
06
04
2023
accepted:
09
06
2023
medline:
10
10
2023
pubmed:
5
7
2023
entrez:
5
7
2023
Statut:
ppublish
Résumé
The development of transcatheter tricuspid edge-to-edge repair for tricuspid regurgitation is a therapeutic milestone but a specific periprocedural risk assessment tool is lacking. TRI-SCORE has recently been introduced as a dedicated risk score for tricuspid valve surgery. This study analyzes the predictive performance of TRI-SCORE following transcatheter edge-to-edge tricuspid valve repair. 180 patients who underwent transcatheter tricuspid valve repair at Ulm University Hospital were consecutively included and stratified into three TRI-SCORE risk groups. The predictive performance of TRI-SCORE was assessed throughout a follow-up period of 30 days and up to 1 year. All patients had severe tricuspid regurgitation. Median EuroSCORE II was 6.4% (IQR 3.8-10.1%), median STS-Score 8.1% (IQR 4.6-13.4%) and median TRI-SCORE 6.0 (IQR 4.0-7.0). 64 patients (35.6%) were in the low TRI-SCORE group, 91 (50.6%) in the intermediate and 25 (13.9%) in the high-risk groups. The procedural success rate was 97.8%. 30-day mortality was 0% in the low-risk group, 1.3% in the intermediate-risk and 17.4% in the high-risk groups (p < 0.001). During a median follow-up of 168 days mortality was 0%, 3.8% and 52.2%, respectively (p < 0.001). The predictive performance of TRI-SCORE was excellent (AUC for 30-day mortality: 90.3%, for one-year mortality: 93.1%) and superior to EuroSCORE II (AUC 56.6% and 64.4%, respectively) and STS-Score (AUC 61.0% and 59.0%, respectively). TRI-SCORE is a valuable tool for prediction of mortality after transcatheter edge-to-edge tricuspid valve repair and its performance is superior to EuroSCORE II and STS-Score. In a monocentric cohort of 180 patients undergoing edge-to-edge tricuspid valve repair TRI-SCORE predicted 30-day and up to one-year mortality more reliably than EuroSCORE II and STS-Score. AUC area under the curve, 95% CI 95% confidence interval.
Sections du résumé
BACKGROUND
BACKGROUND
The development of transcatheter tricuspid edge-to-edge repair for tricuspid regurgitation is a therapeutic milestone but a specific periprocedural risk assessment tool is lacking. TRI-SCORE has recently been introduced as a dedicated risk score for tricuspid valve surgery.
AIMS
OBJECTIVE
This study analyzes the predictive performance of TRI-SCORE following transcatheter edge-to-edge tricuspid valve repair.
METHODS
METHODS
180 patients who underwent transcatheter tricuspid valve repair at Ulm University Hospital were consecutively included and stratified into three TRI-SCORE risk groups. The predictive performance of TRI-SCORE was assessed throughout a follow-up period of 30 days and up to 1 year.
RESULTS
RESULTS
All patients had severe tricuspid regurgitation. Median EuroSCORE II was 6.4% (IQR 3.8-10.1%), median STS-Score 8.1% (IQR 4.6-13.4%) and median TRI-SCORE 6.0 (IQR 4.0-7.0). 64 patients (35.6%) were in the low TRI-SCORE group, 91 (50.6%) in the intermediate and 25 (13.9%) in the high-risk groups. The procedural success rate was 97.8%. 30-day mortality was 0% in the low-risk group, 1.3% in the intermediate-risk and 17.4% in the high-risk groups (p < 0.001). During a median follow-up of 168 days mortality was 0%, 3.8% and 52.2%, respectively (p < 0.001). The predictive performance of TRI-SCORE was excellent (AUC for 30-day mortality: 90.3%, for one-year mortality: 93.1%) and superior to EuroSCORE II (AUC 56.6% and 64.4%, respectively) and STS-Score (AUC 61.0% and 59.0%, respectively).
CONCLUSION
CONCLUSIONS
TRI-SCORE is a valuable tool for prediction of mortality after transcatheter edge-to-edge tricuspid valve repair and its performance is superior to EuroSCORE II and STS-Score. In a monocentric cohort of 180 patients undergoing edge-to-edge tricuspid valve repair TRI-SCORE predicted 30-day and up to one-year mortality more reliably than EuroSCORE II and STS-Score. AUC area under the curve, 95% CI 95% confidence interval.
Identifiants
pubmed: 37405481
doi: 10.1007/s00392-023-02246-9
pii: 10.1007/s00392-023-02246-9
pmc: PMC10562344
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1436-1445Informations de copyright
© 2023. The Author(s).
Références
Bartko PE, Hülsmann M, Hung J, Pavo N, Levine RA, Pibarot P, Vahanian A, Stone GW, Goliasch G (2020) Secondary valve regurgitation in patients with heart failure with preserved ejection fraction, heart failure with mid-range ejection fraction, and heart failure with reduced ejection fraction. Eur Heart J 41(29):2799–2810. https://doi.org/10.1093/eurheartj/ehaa129
doi: 10.1093/eurheartj/ehaa129
pubmed: 32350503
pmcid: 8453270
Benfari G, Antoine C, Miller WL, Thapa P, Topilsky Y, Rossi A, Michelena HI, Pislaru S, Enriquez-Sarano M (2019) Excess mortality associated with functional tricuspid regurgitation complicating heart failure with reduced ejection fraction. Circulation 140(3):196–206. https://doi.org/10.1161/CIRCULATIONAHA.118.038946
doi: 10.1161/CIRCULATIONAHA.118.038946
pubmed: 31117814
Messika-Zeitoun D, Verta P, Gregson J, Pocock SJ, Boero I, Feldman TE, Abraham WT, Lindenfeld J, Bax J, Leon M, Enriquez-Sarano M (2020) Impact of tricuspid regurgitation on survival in patients with heart failure: a large electronic health record patient-level database analysis. Eur J Heart Fail 22(10):1803–1813. https://doi.org/10.1002/ejhf.1830
doi: 10.1002/ejhf.1830
pubmed: 32367642
Topilsky Y, Medina Inojosa J, Benfari G, Vaturi O, Maltais S, Michelena HI, Mankad S, Enriquez-Sarano M (2018) Clinical presentation and outcome of tricuspid regurgitation in patients with systolic dysfunction. Eur Heart J 39(39):3584–3592. https://doi.org/10.1093/eurheartj/ehy434
doi: 10.1093/eurheartj/ehy434
pubmed: 30060125
Neuhold S, Hülsmann M, Pernicka E, Graf A, Bonderman D, Adlbrecht C, Binder T, Maurer G, Pacher R, Mascherbauer J (2013) Impact of tricuspid regurgitation on survival in patients with chronic heart failure: unexpected findings of a long-term observational study. Eur Heart J 34(11):844–852. https://doi.org/10.1093/eurheartj/ehs465
doi: 10.1093/eurheartj/ehs465
pubmed: 23335604
Bartko PE, Arfsten H, Frey MK, Heitzinger G, Pavo N, Cho A, Neuhold S, Tan TT, Strunk G, Hengstenberg C, Hülsmann M, Goliasch G (2019) Natural history of functional tricuspid regurgitation: implications of quantitative doppler assessment. JACC Cardiovasc Imaging 12(3):389–397. https://doi.org/10.1016/j.jcmg.2018.11.021
doi: 10.1016/j.jcmg.2018.11.021
pubmed: 30660536
Lurz P, von Bardeleben RS, Weber M, Sitges M, Sorjja P, Hausleiter J, Denti P, Trochu JN, Nabauer M, Tang GHL, Biaggi P, Ying SW, Trusty PM, Dahou A, Hahn RT, Nickenig G, TRILUMINATE Investigators (2021) Transcatheter edge-to-edge repair for treatment of tricuspid regurgitation. JACC 77(3):229–239. https://doi.org/10.1016/j.jacc.2020.11.038
doi: 10.1016/j.jacc.2020.11.038
pubmed: 33478646
Taramasso M, Maisano F (2017) Novel Technologies for percutaneous treatment of tricuspid valve regurgitation. Eur Heart J 38(36):2707–2710. https://doi.org/10.1093/eurheartj/ehx475
doi: 10.1093/eurheartj/ehx475
pubmed: 29044389
Orban M, Rommel KP, Ho EC, Unterhuber M, Pozzoli A, Connelly KA, Deseive S, Besler C, Ong G, Braun D, Edwards J, Miura M, Gülmez G, Stolz L, Gavazzoni M, Zuber M, Orban M, Nabauer M, Maisano F, Thiele H, Massberg S, Taramasso M, Fam NP, Lurz P, Hausleiter J (2020) Transcatheter edge-to-edge tricuspid repair for severe tricuspid regurgitation reduces hospitalizations for heart failure. JACC Heart Fail 8(4):265–276. https://doi.org/10.1016/j.jchf.2019.12.006
doi: 10.1016/j.jchf.2019.12.006
pubmed: 32241534
Taramasso M, Benfari G, van der Bijl P, Alessandrini H, Attinger-Toller A, Biasco L, Lurz P, Braun D, Brochet E, Connelly KA, de Bruijn S, Denti P, Deuschl F, Estevez-Loureiro R, Fam NP, Frerker C, Gavazzoni M, Hausleiter J, Ho E, Juliard JM, Kaple R, Besler C, Kodali S, Kreidel F, Kuck KH, Latib A, Lauten A, Monivas V, Mehr M, Muntané-Carol G, Nazif T, Nickenig G, Pedrazzini G, Philippon F, Pozzoli A, Praz F, Puri R, Rodés-Cabau J, Schäfer U, Schofer J, Sievert H, Tang GHL, Thiele H, Topilsky Y, Rommel KP, Delgado V, Vahanian A, von Bardeleben RS, Webb JG, Weber M, Windecker S, Winkel M, Zuber M, Leon MB, Hahn RT, Bax JJ, Enriquez-Sarano M, Maisano F (2019) Transcatheter versus medical treatment of patients with symptomatic severe tricuspid regurgitation. JACC 74(24):2998–3008. https://doi.org/10.1016/j.jacc.2019.09.028
doi: 10.1016/j.jacc.2019.09.028
pubmed: 31568868
Kresoja KP, Lauten A, Orban M, Rommel KP, Alushi B, Besler C, Braun D, Unterhuber M, Stangl K, Landmesser U, Massberg S, Thiele H, Hausleiter J, Lurz P (2020) Transcatheter tricuspid valve repair in the setting of heart failure with preserved or reduced left ventricular ejection fraction. Eur J Heart Fail 22(10):1817–1825. https://doi.org/10.1002/ejhf.1975
doi: 10.1002/ejhf.1975
pubmed: 32741057
Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, Capodanno D, Conradi L, De Bonis M, De Paulis R, Delgado V, Freemantle N, Gilard M, Haugaa KH, Jeppsson A, Jüni P, Pierard L, Prendergast BD, Sádaba JR, Tribouilloy C, Wojakowski W, ESC/EACTS Scientific Document Group, ESC National Cardiac Societies (2022) 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 43(7):561–632. https://doi.org/10.1093/eurheartj/ehab395
doi: 10.1093/eurheartj/ehab395
pubmed: 34453165
Shahian DM, Jacobs JP, Badhwar V, Kurlansky PA, Furnary AP, Cleveland JC Jr, Lobdell KW, Vassileva C, Wyler-von-Ballmoos MC, Thourani VH, Rankin JS, Edgerton JR, D’Agostino RS, Desai ND, Feng L, He X, O’Brien SM (2018) The Society of Thoracic Surgeons 2018 adult cardiac surgery risk models: part 1—background, design considerations, and model development. Ann Thorac Surg 105(5):1411–1418. https://doi.org/10.1016/j.athoracsur.2018.03.002
doi: 10.1016/j.athoracsur.2018.03.002
pubmed: 29577925
Nashef SAM, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, Lockowandt U (2012) EuroSCORE II. Eur J Cardiothorac Surg 41(4):734–744. https://doi.org/10.1093/ejcts/ezs043 . (discussion 744–5)
doi: 10.1093/ejcts/ezs043
pubmed: 22378855
Dreyfus J, Audureau E, Bohbot Y, Coisne A, Lavie-Badie Y, Brechery M, Flagiello M, Bazire B, Eggenspieler F, Viau F, Riant E, Mbaki Y, Eyharts D, Senage T, Modine T, Nicol M, Doguet F, Nguyen V, Le Tourneau T, Tribouilloy C, Donal E, Tomasi J, Habib G, Selton-Suty C, Raffoul R, Iung B, Obadia JF, Messika-Zeitoun D (2022) TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery. Eur Heart J 43(7):654–662. https://doi.org/10.1093/eurheartj/ehab679
doi: 10.1093/eurheartj/ehab679
pubmed: 34586392
Omran H, Pfister R, Ehrenfels MA, Körber MI, Baldus S, Friedrichs K, Rudolph V, Iliadis C (2022) Prognostic performance of the surgical TRI-SCORE risk score in patients undergoing transcatheter tricuspid valve treatment. JACC Cardiovasc Interv 15(19):1996–1998. https://doi.org/10.1016/j.jcin.2022.05.031
doi: 10.1016/j.jcin.2022.05.031
pubmed: 36202569
Kumar A, Sato K, Narayanswami J, Banerjee K, Andress K, Lokhande C, Mohananey D, Anumandla AK, Khan AR, Sawant AC, Menon V, Krishnaswamy A, Tuzcu EM, Jaber WA, Mick S, Svensson LG, Kapadia SR (2018) Current society of thoracic surgeons model reclassifies mortality risk in patients undergoing transcatheter aortic valve replacement. Circ Cardiovasc Interv 11(9):e006664. https://doi.org/10.1161/CIRCINTERVENTIONS.118.006664
doi: 10.1161/CIRCINTERVENTIONS.118.006664
pubmed: 30354591
Hojsgaard Jorgensen T, Sondergaard L (2018) Risk assessment for transcatheter aortic valve replacement. Card Interv Today 12(2):40–45
Alba AC, Agoritsas T, Walsh M, Hanna S, Iorio A, Devereaux PJ, McGinn T, Guyatt G (2017) Discrimination and calibration of clinical prediction models—users’ guides to the medical literature. JAMA 318(14):1377–1384. https://doi.org/10.1001/jama.2017.12126
doi: 10.1001/jama.2017.12126
pubmed: 29049590
Galie N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh TA, Pierard LA, Trindade PT, Zompatori M, Hoeper M, ESC Scientific Document Group (2015) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37(1):67–119. https://doi.org/10.1093/eurheartj/ehv317
doi: 10.1093/eurheartj/ehv317
pubmed: 26320113
Hahn RT, Zamorano JL (2018) The need for a new tricuspid regurgitation grading scheme. Eur Hear J Cardiovasc Imaging 18(12):1342–1343. https://doi.org/10.1093/ehjci/jex139
doi: 10.1093/ehjci/jex139
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–271. https://doi.org/10.1093/ehjci/jev014
doi: 10.1093/ehjci/jev014
pubmed: 25712077
Rickham PP (1964) Human experimentation. Code of ethics of the World Medical Association. Declaration of Helsinki. Br Med J 2(5402):177. https://doi.org/10.1136/bmj.2.5402.177
doi: 10.1136/bmj.2.5402.177
pubmed: 14150898
Dreyfus J, Flagiello M, Bazire B, Eggenspieler F, Viau F, Riant E, Mbaki Y, Bohbot Y, Eyharts D, Senage T, Dubrulle H, Nicol M, Doguet F, Nguyen V, Coisne A, Le Tourneau T, Lavie-Badie Y, Tribouilloy C, Donal E, Tomasi J, Habib G, Selton-Suty C, Raffoul R, Iung B, Obadia JF, Messika-Zeitoun D (2020) Isolated tricuspid valve surgery: impact of aetiology and clinical presentation on outcomes. Eur Heart J 41(45):4304–4317. https://doi.org/10.1093/eurheartj/ehaa643
doi: 10.1093/eurheartj/ehaa643
pubmed: 32974668
Russo M, Di Mauro M, Saitto G, Lio A, Berretta P, Taramasso M, Scrofani R, Della Corte A, Sponga S, Greco E, Saccocci M, Calafiore A, Bianchi G, Leviner DB, Biondi A, Livi U, Sharoni E, De Vincentiis C, Di Eusanio M, Antona C, Troise G, Solinas M, Laufer G, Musumeci F, Andreas M (2022) Outcome of patients undergoing isolated tricuspid repair or replacement surgery. Eur J Cardiothorac Surg 62(3):ezac230. https://doi.org/10.1093/ejcts/ezac230
doi: 10.1093/ejcts/ezac230
pubmed: 35448903
Nickenig G, Weber M, Lurz P, von Bardeleben RS, Sitges M, Sorajja P, Hausleiter J, Denti P, Trochu JN, Nabauer M, Dahou A, Hahn RT (2019) Transcatheter edge-to-edge repair for reduction of tricuspid regurgitation: 6-month outcomes of the TRILUMINATE single-arm study. Lancet 394(10213):2002–2011. https://doi.org/10.1016/S0140-6736(19)32600-5
doi: 10.1016/S0140-6736(19)32600-5
pubmed: 31708188
Ghio S, Gavazzi A, Campana C, Inserra C, Klersy C, Sebastiani R, Arbustini E, Recusani F, Tavazzi L (2001) Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. JACC 37(1):183–188. https://doi.org/10.1016/s0735-1097(00)01102-5
doi: 10.1016/s0735-1097(00)01102-5
pubmed: 11153735
Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 17(13):1717–1731. https://doi.org/10.1161/CIRCULATIONAHA.107.653584
doi: 10.1161/CIRCULATIONAHA.107.653584
Gorter TM, van Veldhuisen DJ, Bauersachs J, Borlaug BA, Celutkiene J, Coats AJS, Crespo-Leiro MG, Guazzi M, Harjola VP, Heymans S, Hill K, Lainscak M, Lam CSP, Lund LH, Lyon AR, Mebazaa A, Mueller C, Paulus WJ, Pieske B, Piepoli MF, Ruschitzka F, Rutten FH, Seferovic PM, Solomon SD, Shah SJ, Triposkiadis F, Wachter R, Tschöpe C, de Boer RA (2018) Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 20(1):16–37. https://doi.org/10.1002/ejhf.1029
doi: 10.1002/ejhf.1029
pubmed: 29044932
Wild MG, Löw K, Rosch S, Gercek M, Higuchi S, Massberg S, Nabauer M, Rudolph V, Markovic S, Boekstegers P, Rassaf T, Luedike P, Geisler T, Braun D, Stolz L, Praz F, Lurz P, Hausleiter J, PASTE Investigators (2022) Multicenter experience with the transcatheter leaflet repair system for symptomatic tricuspid regurgitation. JACC Cardiovasc Interv 15(13):1352–1363. https://doi.org/10.1016/j.jcin.2022.05.041
doi: 10.1016/j.jcin.2022.05.041
pubmed: 35798479
Bocchino PP, Angelini F, Vairo A, Andreis A, Fortuni F, Franchin L, Frea S, Raineri C, Pidello S, Conrotto F, Montefusco A, Alunni G, De Ferrari GM (2021) Clinical outcomes following isolated transcatheter tricuspid valve repair: a meta-analysis and meta-regression study. JACC Cardiovasc Interv 14(20):2285–2295. https://doi.org/10.1016/j.jcin.2021.08.050
doi: 10.1016/j.jcin.2021.08.050
pubmed: 34674867