Aims: Several studies have shown an association between tricuspid regurgitation (TR) and renal improvement. This study analyzed whether TR-reduction using transcatheter edge-to-edge repair (T-TEER) improves renal function at mid-term follow-up and the impact of renal function on heart failure hospitalization.

Methods and results: In this prospective single center registry, 192 patients underwent T-TEER between March 2017 and July 2022. Of these, 73 patients with available eGFR at baseline and at 3 months follow-up were further analyzed. Cox regression was used to analyze the impact on heart failure hospitalization. Median age was 79 years [75 – 83] and procedure time 92 minutes [74-131]. T-TEER was successful in 100% of cases, achieving a significant NYHA reduction by 1 class and tricuspid regurgitation by 2 grades (p<0.001 for both).

Median eGFR was 36 [29-51] at baseline and 42 [31-53] ml/min at 3 months follow-up (p<0.001). 

Of 73 patients undergoing T-TEER, 46 (63%) showed eGFR improvement, when compared to baseline eGFR (39 [30-53] vs. 35 [29-44] ml/min; p=0.217). The extent of eGFR improvement at 3-month follow-up was associated with a significant reduction of heart failure hospitalization with each eGFR point (HR 0.93, 95%-CI 0.86-0.99; p=0.045). Clinical and procedural characteristics were not able to predict eGFR improvement at 3-month follow-up.

Conclusion: Tricuspid edge-to-edge repair displays an effective therapy option in symptomatic tricuspid regurgitation. Beyond significant reduction of TR and improved NYHA class, especially eGFR improvement was evident in the majority of patients at mid-term follow-up leading to significant reduction of heart failure hospitalization.