Highlights
- •We evaluated prognosis of a large number of patients with severe tricuspid regurgitation (TR) (N = 1001).
- •A considerable number of patients (22 %) had isolated functional TR.
- •Renal function and anemia are prognostic predictors of isolated functional TR.
Abstract
Background
A substantial number of patients have functional tricuspid regurgitation (TR).
Isolated functional TR has been undertreated and may be a next target for transcatheter
intervention. However, the prevalence, patient characteristics, and predictive factors
for prognosis remain unclear.
Methods
From patients in our echocardiographic database (N = 64,242), we extracted those with severe TR and examined prognosis according to
etiologies of TR. Thereafter, we focused on two types of isolated functional TR; progressive
TR after left-sided valve surgery (postoperative TR) and TR associated with annular
dilatation (atrial TR). Composite adverse events were defined as all-cause death or
hospitalization for heart failure (HF).
Results
Of 1001 patients with severe TR (median age, 77 years; female, 58 %), 71 (7 %) patients
were classified as postoperative TR, and 149 (15 %) as atrial TR. During the follow-up
period (median, 1.6 years), 30 composite adverse events were observed (postoperative
TR, n = 14; atrial TR, n = 16). Composite adverse events were less frequent in these two types of functional
TR than TR of other etiologies. Multivariate analysis adjusted for age and sex showed
that a history of hospitalization for HF, history of cardiac surgery >2 times, loop
diuretics, estimated glomerular filtration rate, blood urea nitrogen, hemoglobin,
platelet level, left ventricular ejection fraction, and right ventricular dimension
were associated with clinical adverse events (p < 0.05), while B-type natriuretic peptide level was not.
Conclusions
A considerable number of patients had isolated functional TR. Extracardiac factors
such as renal function, hemoglobin and platelet are important in determining clinical
outcomes.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: January 03, 2023
Accepted:
December 7,
2022
Received in revised form:
November 23,
2022
Received:
October 14,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
