Advanced Imaging Assessment of the Impact of Tricuspid Regurgitation on Cardiac Remodeling: The TRILUMINATE Pivotal Imaging Substudy

Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.