{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:29:02Z","timestamp":1778754542172,"version":"3.51.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1396,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Several new percutaneous tricuspid repair systems have recently been introduced as new treatment options for severe tricuspid regurgitation (TR). Clinical improvement following percutaneous tricuspid valve leaflet repair has been demonstrated by recent studies. A possible impact on exercise capacity has not yet been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Eleven patients with at least severe TR and successful tricuspid leaflet repair using the PASCAL Ace implant at our cardiology department were included in this analysis. All patients suffered from symptomatic right-sided heart failure with compromised exercise capacity. Cardiopulmonary exercise testing (CPET), clinical, laboratory, and echocardiographic parameters were assessed at baseline and 3 months follow-up. The primary endpoint was the change in maximal oxygen consumption [VO2 max (mL\/(min*kg))] at 3 months follow-up. Secondary endpoints included improvement in TR, cardiac biomarkers, and other clinical outcomes. TR severity at 3 months follow-up post-PASCAL Ace implantation was significantly lower than at baseline (P = 0.004). Cardiac biomarkers including high-sensitivity troponin T and N-terminal pro-brain natriuretic peptide as well as right ventricular diameter improved slightly without reaching statistical significance (P = 0.89, P = 0.32, and P = 0.06, respectively). PASCAL Ace implantation resulted in a significant improvement in cardiopulmonary exercise capacity at 3 months follow-up compared with baseline. Mean VO2 max improved from 9.5 \u00b1 2.8 to 11.4 \u00b1 3.4 mL\/(min*kg) (P = 0.006), VO2 max per cent predicted from 42 \u00b1 12% to 50 \u00b1 15% (P = 0.004), peak oxygen uptake from 703 \u00b1 175 to 826 \u00b1 198 mL\/min (P = 0.004), and O2 pulse per cent predicted from 67 \u00b1 21% to 81 \u00b1 25% (P = 0.011). Other CPET-related outcomes did not show any significant change over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this single-centre retrospective analysis, direct tricuspid valve leaflet repair using the transcatheter PASCAL Ace implant system was associated with a reduced TR severity and improved cardiopulmonary exercise capacity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13831","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:30:24Z","timestamp":1644366624000},"page":"866-873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Functional Improvement Following Direct Interventional Leaflet Repair of Severe Tricuspid Regurgitation"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-4516","authenticated-orcid":false,"given":"Martin J.","family":"Volz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Hoerbrand","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias H.","family":"Konstandin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg\/Mannheim ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derliz","family":"Mereles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celine","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Warnecke","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Heidelberg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg\/Mannheim ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Aurich","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip W.","family":"Raake","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg\/Mannheim ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"2026012114170586500_ehf213831-bib-0001","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jcmg.2018.06.014","article-title":"Burden of tricuspid regurgitation in patients diagnosed in the community 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