New research presented at THT 2026 suggests that the NT-proBNP biomarker could give us a glimpse into which patients with severe tricuspid regurgitation (TR) will benefit the most from transcatheter edge-to-edge repair (TEER).
- NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a key blood biomarker used to diagnose, rule out, and manage heart failure by measuring cardiac stress.
- TEER for severe TR is proven to improve symptoms and reduce heart failure hospitalizations, but predicting treatment success has been difficult.
Using data from the EuroTR registry, researchers evaluated 2.2k patients undergoing TEER, and organized them into three NT-proBNP categories (≤1,674, 1,675-3,743, >3,743 pg/mL) to compare baseline levels plus 30-day trajectory changes, finding that…
- Higher baseline NT-proBNP was associated with a greater 2-year composite mortality or first HF hospitalization risk (aHR: 1.62).
- Patients in the highest NT-proBNP category showed less functional improvement and less procedural success (81.4% in the highest vs. 86.3% in the lowest).
The 30-day NT-proBNP levels also predicted outcomes in patients who started at high baseline and saw their levels increase more than 30%.
- Patients like these faced a 36% event-free survival rate versus 76% in the low NT-proBNP group.
While the study demonstrated NT-proBNP’s prognostic value, it also raised questions about the study population, since the extremely elevated baseline NT-proBNP levels suggest patients might not have been on optimal GDMT prior to TEER.
- Only 26% of patients received SGLT2is despite guidelines, while 43.9% were on MRAs and 57.4% were on RASis.
The Takeaway
When it comes to a complex procedure like transcatheter edge-to-edge repair for severe TR, being able to predict a patient’s response to treatment is invaluable. This study suggests that NT-proBNP could help do that, so long as physicians know a patient’s GDMT history.
