Left atrial remodeling and diastolic unloading after transcatheter tricuspid repair

Information from the abstract

BACKGROUND: Severe tricuspid regurgitation (TR) alters ventricular interaction and left-sided filling dynamics. However, the longitudinal effects of transcatheter tricuspid edge-to-edge repair (T-TEER) on left atrial (LA) remodeling and diastolic physiology remain poorly characterized. AIMS: To evaluate longitudinal changes in LA structure, function, and diastolic hemodynamics following T-TEER. METHODS: We studied 125 consecutive patients undergoing T-TEER within the TRI-FR trial and registry (median age 78 [73-81] years; 60.8% women; 73.6% atrial fibrillation). Comprehensive echocardiography was performed at baseline, pre-discharge, and at 6 and 12 months. Longitudinal changes in LA volume index (LAVI), peak atrial longitudinal strain (PALS), E/e' ratio, left atrial stiffness index (LASI), and forward flow indices were analysed using linear mixed-effects models. RESULTS: LAVI decreased immediately after T-TEER (estimated change -8.1 mL/m2; 95% CI -14.6 to -1.6; adjusted P=0.033), but this reverse remodeling was not sustained at 12 months. In contrast, LA reservoir function deteriorated early and remained impaired throughout follow-up (PALS -1.2%; 95% CI -2.0 to -0.3; adjusted P=0.029). Estimated LV filling pressure increased acutely (E/e' +3.26; 95% CI 2.34-4.18; adjusted P

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Related topics: Cardiovascular Function and Risk Factors · Cardiac Valve Diseases and Treatments · Atrial Fibrillation Management and Outcomes