Left atrial remodeling and diastolic unloading after transcatheter tricuspid repair

Abstract Background Severe tricuspid regurgitation (TR) elevates left-heart filling pressures via septal shift. Whether transcatheter tricuspid edge-to-edge repair (T-TEER) reverses these changes remains uncertain. Purpose To quantify left-atrial (LA) volume and diastolic-pressure surrogates after T-TEER. Methods In 108 consecutive patients we measured LA volume index (LAVI), E/e′ ratio, peak atrial longitudinal strain (PALS) and LA stiffness index (LASI = E/e′⁄PALS) at baseline, predischarge (PreDC), 6 months and 12 months. Time effects were assessed with patient-level linear mixed-effects models; patients were stratified by baseline left-ventricular ejection fraction (LVEF) ≥ or < 50 %. Results LAVI fell by PreDC (Δ –6.1 mL/m²; p