Trans-C versus Cis-C thermally induced isomerisation of a terpyridine adduct of cytotoxic cycloruthenated compound

International audienceTwo novel cycloruthenated compounds, 2 and 3, derived from cycloruthenated 2-phenyl pyridine(Ru(PhPy)) have been synthesized by adding one equivalent of 2,20;60,200-terpyridine (terpy) to [Ru(2-C6H4-20-C5H4N-kC,N)(MeCN)4]PF6 in MeOH/MeCN (16:1) at reflux temperature as a mixture of 1:1 isomers. The structures of both compounds that were formed under kinetic and thermodynamic control respectively, differ by the position of the central pyridine unit of terpy that was found trans or cis to the C-Ru bond of the Ru(PhPy) unit for 2 and 3 respectively. Whereas 2 did not afford substitution reactions when treated with any ligand, the substitution by MeOH or H2O of the MeCN trans to C in 3 could be followed by UV-vis spectroscopy. Moreover, the reaction in MeOH between 3 and imidazoles afforded new cycloruthenated compounds, 6a and 6b whose cytotoxicities, together with that of 2 and 3, against HCT116 and AGS cancer cells were determined

Residual tricuspid regurgitation after tricuspid transcatheter edge-to-edge repair: Insights into the EuroTR registry.

AIMS Data on the prognostic impact of residual tricuspid regurgitation (TR) after tricuspid transcatheter edge-to-edge repair (T-TEER) are scarce. The aim of this analysis was to evaluate 2-year survival and symptomatic outcomes of patients in relation to residual TR after T-TEER. METHODS AND RESULTS Using the large European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR registry) we investigated the impact of residual TR on 2-year all-cause mortality and New York Heart Association (NYHA) functional class at follow-up. The study further identified predictors for residual TR ≥3+ using a logistic regression model. The study included a total of 1286 T-TEER patients (mean age 78.0 ± 8.9 years, 53.6% female). TR was successfully reduced to ≤1+ in 42.4%, 2+ in 40.0% and 3+ in 14.9% of patients at discharge, while 2.8% remained with TR ≥4+ after the procedure. Residual TR ≥3+ was an independent multivariable predictor of 2-year all-cause mortality (hazard ratio 2.06, 95% confidence interval 1.30-3.26, p = 0.002). The prevalence of residual TR ≥3+ was four times higher in patients with higher baseline TR (vena contracta >11.1 mm) and more severe tricuspid valve tenting (tenting area >1.92 cm2). Of note, no survival difference was observed in patients with residual TR ≤1+ versus 2+ (76.2% vs. 73.1%, p = 0.461). The rate of NYHA functional class ≥III at follow-up was significantly higher in patients with residual TR ≥3+ (52.4% vs. 40.5%, p < 0.001). Of note, the degree of TR reduction significantly correlated with the extent of symptomatic improvement (p = 0.012). CONCLUSIONS T-TEER effectively reduced TR severity in the majority of patients. While residual TR ≥3+ was associated with worse outcomes, no differences were observed for residual TR 1+ versus 2+. Symptomatic improvement correlated with the degree of TR reduction