GLIDE Score: Scoring System for Prediction of Procedural Success in Tricuspid Valve Transcatheter Edge-to-Edge Repair,JACC: Cardiovascular Imaging

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GLIDE Score: Scoring System for Prediction of Procedural Success in Tricuspid Valve Transcatheter Edge-to-Edge Repair
JACC: Cardiovascular Imaging ( IF 12.8 ) Pub Date : 2024-06-05 , DOI: 10.1016/j.jcmg.2024.04.008
Muhammed Gerçek ₁ , Akhil Narang ₂ , M Isabel Körber ₃ , Kai P Friedrichs ₄ , Jyothy J Puthumana ₂ , Maria Ivannikova ₄ , Mohamed Al-Kazaz ₂ , Paul Cremer ₂ , Abigail S Baldridge ₂ , Zhiying Meng ₂ , Peter Luedike ₅ , James D Thomas ₂ , Tanja K Rudolph ₄ , Tobias Geisler ₆ , Tienush Rassaf ₅ , Roman Pfister ₃ , Volker Rudolph ₄ , Charles J Davidson ₂

Affiliation

Tricuspid valve transcatheter edge-to-edge repair (T-TEER) is the most widely used transcatheter therapy to treat patients with tricuspid regurgitation (TR). The aim of this study was to develop a simple anatomical score to predict procedural outcomes of T-TEER. All patients (n = 168) who underwent T-TEER between January 2017 and November 2022 at 2 centers were included in the derivation cohort. Additionally, 126 patients from 2 separate institutions served as a validation cohort. T-TEER was performed using 2 commercially available technologies. Core laboratory assessment of procedural transesophageal echocardiograms was used to determine septolateral and anteroposterior coaptation gap, leaflet morphology, septal leaflet length and retraction, chordal structure density, tethering height, en face TR jet morphology and TR jet location, image quality, and the presence of intracardiac leads. A scoring system was derived using univariable and multivariable logistic regression. Endpoints assessed were immediate postprocedural TR reduction ≥2 grades and TR grade moderate or less. The median age was 82 years (Q1-Q3: 78-84 years); 48% of patients were women; and patients presented with severe (55%), massive (36%), and torrential (8%) TR. Five variables (septolateral coaptation gap, chordal structure density, en face TR jet morphology, TR jet location, and image quality) were identified as best predicting procedural outcome and were incorporated in the GLIDE (Gap, Location, Image quality, density, en-face TR morphology) score (range 0-5). TR reduction ≥2 grades and TR grade moderate or less were observed in >90% of patients with GLIDE scores of 0 and 1 and in only 5.6% and 16.7% of those with GLIDE scores ≥4. The GLIDE score was then externally validated in a separate cohort (area under the curve: 0.77; 95% CI: 0.69-0.86). TR reduction significantly correlated with functional improvement assessed by NYHA functional class and 6-minute walk distance at 3 months. The GLIDE score is a simple, 5-component score that is readily obtained during patient imaging and can predict successful T-TEER.

中文翻译：

GLIDE 评分：预测三尖瓣经导管边对边修复手术成功率的评分系统

三尖瓣经导管边对边修复术 (T-TEER) 是治疗三尖瓣反流 (TR) 患者最广泛使用的经导管疗法。本研究的目的是开发一个简单的解剖评分来预测 T-TEER 的手术结果。 2017 年 1 月至 2022 年 11 月期间在 2 个中心接受 T-TEER 的所有患者 (n = 168) 均纳入衍生队列。此外，来自 2 个不同机构的 126 名患者作为验证队列。 T-TEER 使用 2 种商用技术进行。程序性经食管超声心动图的核心实验室评估用于确定间隔外侧和前后接合间隙、瓣叶形态、间隔瓣叶长度和回缩、腱索结构密度、栓系高度、正面TR射流形态和TR射流位置、图像质量以及是否存在心内导联。使用单变量和多变量逻辑回归导出评分系统。评估的终点为术后立即 TR 降低 ≥2 级以及 TR 等级中等或更低。中位年龄为82岁（Q1-Q3：78-84岁）； 48%的患者是女性；患者出现严重（55%）、大量（36%）和急流（8%）TR。五个变量（间隔接合间隙、弦结构密度、正面 TR 射流形态、TR 射流位置和图像质量）被确定为最佳预测程序结果，并纳入 GLIDE（间隙、位置、图像质量、密度、en-面部TR形态）评分（范围0-5）。在 >90% GLIDE 评分为 0 和 1 的患者中观察到 TR 降低 ≥2 级和 TR 中度或更低，而在 GLIDE 评分 ≥ 4 的患者中仅 5.6% 和 16.7% 观察到 TR 降低 ≥2 级和 TR 中度或更低。然后，GLIDE 评分在一个单独的队列中进行外部验证（曲线下面积：0.77；95% CI：0.69-0.86）。 TR 减少与 NYHA 功能等级和 3 个月时 6 分钟步行距离评估的功能改善显着相关。 GLIDE 评分是一个简单的 5 部分评分，可在患者成像过程中轻松获得，并且可以预测成功的 T-TEER。

更新日期：2024-06-05

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