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Association of NT-proBNP With Clinical Outcomes in Patients Undergoing Transcatheter Tricuspid Valve Intervention
Athanasios Feidakis1, Jan Althoff1, Thorsten Gietzen1
1Faculty of Medicine and University Hospital Cologne, Department III of Internal Medicine, University of Cologne, Cologne, Germany.
Background:
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a well-established biomarker for risk stratification in heart failure. However, its prognostic value and early postprocedural dynamics in patients undergoing transcatheter tricuspid valve intervention (TTVI) remain incompletely defined.
Objectives:
The objective of the study was to investigate the association of baseline NT-proBNP levels and early postinterventional NT-proBNP changes with long-term all-cause mortality and symptomatic improvement after TTVI.
Methods:
We analyzed a cohort of patients with severe tricuspid regurgitation undergoing TTVI. Patients were stratified according to baseline NT-proBNP tertiles. Changes in NT-proBNP between baseline and 4-week follow-up were assessed, and their association with long-term all-cause mortality was evaluated using Kaplan-Meier analysis and Cox regression. NYHA functional class improvement (≥1 class) at 4 weeks was analyzed as a secondary endpoint using logistic regression.
Results:
Higher baseline NT-proBNP levels were independently associated with increased long-term all-cause mortality. Early NT-proBNP changes provided additional prognostic information: patients with increasing NT-proBNP levels at 4 weeks showed markedly worse survival, irrespective of procedural success. In contrast, baseline NT-proBNP was not associated with symptomatic improvement according to NYHA functional class at 4-week follow-up. Patients with increasing NT-proBNP levels exhibited larger right atrial volumes and higher right atrial pressures at baseline, suggesting more advanced right-sided remodeling.
Conclusions:
In patients undergoing TTVI, baseline NT-proBNP levels and early postprocedural increases in NT-proBNP identify individuals at high risk for long-term mortality but do not predict symptomatic improvement. NT-proBNP reflects residual myocardial stress rather than procedural success and may aid in patient selection and early postinterventional surveillance.
