Rafael De la Espriella1, Enrique Santas1, Francisco J Chorro1, Gema Miñana1, Meritxell Soler1, Vicent Bodí1, Ernesto Valero1, Eduardo Núñez1, Antoni Bayés-Genis2, Josep Lupón2, Juan Sanchis1, Julio Núñez3. 1. Cardiology Department, Hospital Clínico Universitario, Valencia, Spain; INCLIVA, Spain; Universitat de València, Valencia, Spain; CIBER Cardiovascular, Spain. 2. CIBER Cardiovascular, Spain; Cardiology Service and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain. 3. Cardiology Department, Hospital Clínico Universitario, Valencia, Spain; INCLIVA, Spain; Universitat de València, Valencia, Spain; CIBER Cardiovascular, Spain. Electronic address: yulnunez@gmail.com.
Abstract
BACKGROUND: Functional tricuspid regurgitation (TR) is a common echocardiographic finding in patients with heart failure (HF), and its role in disease progression and prognosis stratification is becoming increasingly relevant in recent years. However, data regarding its association with the burden of HF-readmission is scarce. In this work, we sought to evaluate the association between TR severity and HF-related readmissions following a hospitalization for acute heart failure (AHF). METHODS: We prospectively included a cohort of 2101 patients admitted with the diagnosis of AHF. TR severity was assessed using a multiparametric integrative approach, and classified as none, mild, moderate, and severe. We used negative binomial regression to identify the association between TR grade and HF-related recurrent admissions. The risk associated to severity of TR was expressed as incidence rate ratio (IRR). RESULTS: At a median follow-up of 2.53 years (IQR: 1.03-4.36), 978 (46.5%) patients died, and 1657 HF-readmissions occurred in 842 patients (40.0%). The proportion of patients with two or more admissions was 18.4%. The proportion of patients with moderate to severe TR was 17.2%. There was a stepwise increase in the incidence of readmissions from none to severe TR. After multivariable adjustment, only patients with severe TR were independently associated with higher risk of recurrent HF admissions (IRR = 1.34, CI 95%: 1.05-1.71; p = .019). CONCLUSIONS: In patients with AHF, severe functional TR is independently associated with an increased risk of long-term recurrent HF hospitalizations.
BACKGROUND:Functional tricuspid regurgitation (TR) is a common echocardiographic finding in patients with heart failure (HF), and its role in disease progression and prognosis stratification is becoming increasingly relevant in recent years. However, data regarding its association with the burden of HF-readmission is scarce. In this work, we sought to evaluate the association between TR severity and HF-related readmissions following a hospitalization for acute heart failure (AHF). METHODS: We prospectively included a cohort of 2101 patients admitted with the diagnosis of AHF. TR severity was assessed using a multiparametric integrative approach, and classified as none, mild, moderate, and severe. We used negative binomial regression to identify the association between TR grade and HF-related recurrent admissions. The risk associated to severity of TR was expressed as incidence rate ratio (IRR). RESULTS: At a median follow-up of 2.53 years (IQR: 1.03-4.36), 978 (46.5%) patients died, and 1657 HF-readmissions occurred in 842 patients (40.0%). The proportion of patients with two or more admissions was 18.4%. The proportion of patients with moderate to severe TR was 17.2%. There was a stepwise increase in the incidence of readmissions from none to severe TR. After multivariable adjustment, only patients with severe TR were independently associated with higher risk of recurrent HF admissions (IRR = 1.34, CI 95%: 1.05-1.71; p = .019). CONCLUSIONS: In patients with AHF, severe functional TR is independently associated with an increased risk of long-term recurrent HF hospitalizations.
Authors: Antoni Bayes-Genis; Felipe Bisbal; Julio Núñez; Enrique Santas; Josep Lupón; Patrick Rossignol; Walter Paulus Journal: J Clin Med Date: 2020-04-13 Impact factor: 4.964