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Psoas muscle area (PMA) measured using computed tomography (CT) is known as a marker of sarcopenia. We investigated the association of PMA with procedural and clinical outcomes following TTVR. We retrospectively measured left and right PMA using pre-procedural CT in patients undergoing TTVR. Low PMA was defined as the total PMA\u2009&lt;\u200920.3 cm<jats:sup>2<\/jats:sup> for men and\u2009&lt;\u200911.8 cm<jats:sup>2<\/jats:sup> for women. The primary outcome was a composite of all-cause mortality and heart failure hospitalization within one year after TTVR. Of 163 patients, 47 (29%) were considered as having low PMA. Procedural success, defined as residual TR of\u2009\u2264\u20092\u2009+\u2009at discharge, and in-hospital mortality were comparable between patients with low and high PMA. Patients with low PMA had a higher incidence of the composite outcome than those with high PMA (49% vs. 21%; p\u2009=\u20090.001) This association was consistent after adjusting for baseline characteristics (adjusted hazard ratio 0.43; 95% confidence interval: 0.23\u20130.80; p\u2009=\u20090.008). In contrast, the New York Heart Association functional class improved from baseline to three-month follow-up, regardless of PMA. Approximately 30% of patients undergoing TTVR were found to have low PMA. Although TTVR may be a safe therapeutic option to reduce TR and improve heart failure symptoms in patients with sarcopenia, the prognosis after TTVR remains poor in this population. Pre-procedural CT-based assessment of PMA may enhance risk stratification and support better clinical decision-making for TTVR.<\/jats:p>\n          <jats:p>\n            <jats:bold>Graphical abstract<\/jats:bold>\n          <\/jats:p>\n          <jats:p>Psoas muscle area and outcomes after transcatheter tricuspid valve repair Patients with low psoas muscle area (PMA) had a higher incidence of all-cause mortality (upper right) and heart failure hospitalization (lower right). CT = computed tomography.<\/jats:p>","DOI":"10.1007\/s12928-025-01136-3","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T04:12:00Z","timestamp":1748319120000},"page":"679-688","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Association between psoas muscle area and outcomes after transcatheter tricuspid valve repair"],"prefix":"10.1007","volume":"40","author":[{"given":"Mahmoud","family":"Balata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0780-8689","authenticated-orcid":false,"given":"Tetsu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Sugiura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Refik","family":"Kavsur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Vogelhuber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Zimmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Luetkens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"issue":"20","key":"1136_CR1","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1056\/NEJMra2216709","volume":"388","author":"RT Hahn","year":"2023","unstructured":"Hahn RT. 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Atsushi Sugiura has received honoraria for lectures from Edwards Lifesciences. Georg Nickenig has received research funding from the Deutsche Forschungsgemeinschaft, the German Federal Ministry of Education and Research, the EU, Abbott, Edwards Lifesciences, Medtronic, and St. Jude Medical and has received honoraria for lectures or advisory boards from Abbott, Edwards Lifesciences, Medtronic, and St. Jude Medical. Marcel Weber has received lecture or proctoring fees from Abbott and Edwards. The other authors have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"The authors confirm that patient consent is not applicable to this article. This is a retrospective study using de-identified data; therefore, the IRB did not require consent from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent statement"}}]}}