<p>Tricuspid transcatheter edge-to-edge repair (T-TEER) is an effective treatment for severe tricuspid regurgitation in ineligible surgical candidates. However, data on independent risk factors for adverse outcomes remain limited. This study assessed the prognostic value of the original cardiac power formula incorporating right atrial pressure into the cardiac power index (CPI_RAP) for 1-year outcomes in T-TEER patients. Between August 2020 and June 2023, 107 patients with severe symptomatic tricuspid regurgitation underwent T-TEER and were followed prospectively. Baseline clinical and invasive hemodynamic parameters, echocardiographic changes, functional class, and major adverse events were evaluated. The primary endpoint was 1-year all-cause mortality. CPI_RAP was calculated as the product of the difference between the mean arterial pressure and right atrial pressure, multiplied by the cardiac index, and divided by the correction factor 451. Multivariate Cox regression and receiver operating characteristic analysis determined mortality predictors and the optimal CPI_RAP threshold. The cohort (mean age 81 ± 6 years, 53% female) had a 1-year mortality of 29%. CPI_RAP had an area under the curve of 0.62. A threshold of 0.37&#xa0;W/m² showed 82% sensitivity and 47% specificity for mortality prediction. Event-free survival was higher with CPI_RAP ≥ 0.37&#xa0;W/m² (87% vs. 62%, <i>p</i> = 0.007). CPI_RAP independently predicted mortality (HR 0.59; 95% CI 0.38–0.90; <i>p</i> = 0.016). CPI_RAP, which incorporates right atrial pressure, provides a more comprehensive assessment of cardiac work compared to simplified formulas, and is associated with 1-year mortality, aiding risk stratification in T-TEER candidates.</p> Graphical Abstract <p>Dichotomization of the study cohort based on right heart catheterization, using the CPI_RAP formula (white box) and survival analysis for all-cause mortality one year following T-TEER. Kaplan-Meier survival curves illustrate the association between CPI_RAP values and survival probability over 12 months. Patients with CPI_RAP ≥ 0.37 W/m² (blue line) exhibit significantly better survival compared to those with CPI_RAP 0.37 W/m² (red line), as indicated by the log-rank test (p = 0.007). The table below the graph shows the number of at-risk patients and the cumulative number of events at each time point. Restricted cubic spline plot demonstrating the continuous relationship between the CPI_RAP and HR. The solid line represents the HR, whereas the shaded area indicates the 95% confidence interval. A higher CPI_RAP value was consistently associated with reduced hazard. The circle indicates the value of Youden’s J statistic used for dichotomization. The square represents the mean of the high CPI_RAP group, whereas the triangle represents the mean of the low CPI_RAP group. CI = Cardiac index, CPIRAP = Right Atrial Pressure-Corrected Cardiac Power Index, HR = Hazard ratio, MAP = Mean arterial pressure, RAP = Right atrial pressure, T-TEER = Tricuspid Transcatheter Edge-to-Edge Repair.</p> <p></p>