Assessment of the GLIDE Score for Prediction of Mild Tricuspid Regurgitation following Tricuspid Transcatheter Edge-to-Edge Repair

Felix Rudolph; Akhil Narang; Maria I Körber; Kai P Friedrichs; Johannes Kirchner; Maria Ivannikova; Paul Cremer; Peter Luedike; Tanja K Rudolph; Tobias Geisler; Tienush Rassaf; Roman Pﬁster; Fabien Praz; Volker Rudolph; Charles J Davidson; Mohammad Kassar; Muhammed Gerçek

doi:10.1016/j.jacadv.2024.101523

Assessment of the GLIDE Score for Prediction of Mild Tricuspid Regurgitation following Tricuspid Transcatheter Edge-to-Edge Repair

JACC Adv. 2025 Feb;4(2):101523. doi: 10.1016/j.jacadv.2024.101523.

Authors

Felix Rudolph¹, Akhil Narang², Maria I Körber³, Kai P Friedrichs⁴, Johannes Kirchner⁴, Maria Ivannikova⁴, Paul Cremer², Peter Luedike⁵, Tanja K Rudolph⁴, Tobias Geisler⁶, Tienush Rassaf⁵, Roman Pﬁster³, Fabien Praz⁷, Volker Rudolph⁴, Charles J Davidson², Mohammad Kassar⁸, Muhammed Gerçek⁹

Affiliations

¹ Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany; Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany. Electronic address: frudolph@hdz-nrw.de.
² Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
³ Department for Internal Medicine III, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁴ Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany; Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany.
⁵ Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
⁶ Department of Cardiology and Angiology, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Germany.
⁷ Department of Cardiology, Inselspital, Bern, Switzerland.
⁸ Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany; Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany; Department of Cardiology, Inselspital, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland.
⁹ Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany; Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Abstract

Background: The GLIDE Score is an anatomical scoring system designed to predict moderate residual tricuspid regurgitation (TR) immediately following transcatheter tricuspid edge-to-edge repair (T-TEER).

Objectives: The purpose of this study was to evaluate the GLIDE Score's predictive capability for achieving a postprocedural TR grade of mild or better.

Methods: This retrospective analysis included 336 patients from a multicenter registry who underwent T-TEER between January 2017 and November 2022. Anatomical features were assessed using transesophageal echocardiography to calculate the GLIDE Score, which ranges from 0 to 5. The primary endpoint was a postprocedural TR grade of mild or better, assessed via periprocedural imaging. Outcomes were compared between patients with GLIDE Scores of 0 to 1 and those with scores ≥2 using logistic regression and ROC curve analysis.

Results: Median age was 81 years, with no significant differences in BMI, EuroScore II, or NYHA Class across GLIDE Score cohorts. The GLIDE Score ≥2 cohort had a larger median RV basal diameter (48 mm vs 45 mm, P < 0.001) and more torrential TR cases (35.9% vs 3.1%, P < 0.001). Postprocedural mild TR was achieved in 74.7% of patients with a GLIDE Score of 0 to 1, versus 13.4% in the ≥2 cohort (P < 0.001). Ordinal regression analysis found a strong correlation between the GLIDE Score and postprocedural TR severity (coefficient = 1.41, t = 12.92), with an AUC to predict mild TR of 0.87 (95% CI: 0.83-0.90).

Conclusions: The GLIDE Score is a valuable tool for predicting postprocedural TR severity in T-TEER patients, guiding patient selection and refining treatment strategies.

Keywords: GLIDE score; mild tricuspid regurgitation; procedural success; transcatheter edge-to-edge repair; transcatheter therapy.