GLIDE Score is associated with procedural success in patients undergoing direct transcatheter tricuspid valve annuloplasty

AIMS: The GLIDE Score (septolateral gap, predominant jet location, image quality, chordal structure density, and en-face jet morphology) may predict successful tricuspid transcatheter edge-to-edge repair. This study aimed to evaluate its predictive value in transcatheter tricuspid valve annuloplasty (TTVA). METHODS AND RESULTS: This study was performed on 204 consecutive patients who underwent TTVA between 2018 and 2023 at two tertiary German centres. The GLIDE Score was assessed using preprocedural transoesophageal echocardiograms.Residual tricuspid regurgitation (TR) grade ≤ I was achieved in 44.6% of cases; 83.7% had a TR reduction of ≥2 grades and 72.8% a residual TR grade ≤ II. Lower GLIDE Scores were significantly associated with higher rates of residual TR ≤ I, residual TR ≤ II (P < 0.001), and TR reduction of ≥2 grades (P = 0.001). Residual TR ≤ I was achieved in 79% of patients with a score of 0-1, compared to 19% with scores of ≥4. After adjustment for baseline TR grade, the GLIDE Score was still independently associated with procedural outcomes. In this TTVA cohort, a modified GLIDE Score, excluding chordal structure density and including anteroseptal and bicommissural annular diameters, demonstrated strong predictive performance, with an area under the curve of 0.84 [original GLIDE Score 0.79 (95% CI: 0.72-0.85)] in the main cohort and 0.76 in an external validation cohort (n = 86). CONCLUSION: The GLIDE Score reliably identifies patients with a high likelihood of achieving procedural success after TTVA. Incorporating annular diameters may further improve predictive accuracy and guide treatment selection in patients undergoing transcatheter tricuspid valve repair.