GLIDE Score: Scoring System for Prediction of Procedural Success in Tricuspid Valve Transcatheter Edge-to-Edge Repair.

Background: Tricuspid valve transcatheter edge-to-edge repair (T-TEER) is the most widely used transcatheter therapy to treat patients with tricuspid regurgitation (TR).
Objectives: The aim of this study was to develop a simple anatomical score to predict procedural outcomes of T-TEER.
Methods: 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.
Results: 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.
Conclusions: The GLIDE score is a simple, 5-component score that is readily obtained during patient imaging and can predict successful T-TEER.
Competing Interests: Funding Support and Author Disclosures Research reported in this publication was supported in part by the Bluhm Cardiovascular Institute Clinical Trials Unit at the Northwestern University Feinberg School of Medicine. Dr Gerçek has received research grants from the German Heart Foundation. Dr Narang has received speaker honoraria from Edwards Lifesciences. Dr Puthumana has received speaker honoraria from Abbott. Drs V. Rudolph and T. Rudolph have received grants and speaker honoraria from Abbott and Edwards Lifesciences. Dr Thomas has received consulting fees from Abbott, GE, egnite, EchoIQ, and Caption Health. Dr Luedike has received speaker honoraria and consulting fees from AstraZeneca, Bayer, Pfizer, and Edwards Lifesciences; and has received research honoraria from Edwards Lifesciences. Dr Rassaf has received speaker honoraria and consulting fees from AstraZeneca, Bayer, Pfizer, and Daiichi-Sankyo (outside the submitted work). Dr Davidson has received grants from Abbott and Edwards Lifesciences; is an uncompensated consultant for Edwards Lifesciences; and has received honoraria from Philips Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)