Ehud Chorin1, Zach Rozenbaum1, Yan Topilsky1, Maayan Konigstein1, Tomer Ziv-Baran2, Eyal Richert1, Gad Keren1, Shmuel Banai1. 1. Department of Cardiology, Tel Aviv Medical Center and Sackler School of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, Israel. 2. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
AIMS: Tricuspid regurgitation (TR) is a frequent echocardiographic finding; however, its effect on outcome is unclear. The objectives of current study were to evaluate the impact of TR severity on heart failure hospitalization and mortality. METHODS AND RESULTS: We retrospectively reviewed consecutive echocardiograms performed between 2011 and 2016 at the Tel-Aviv Medical Center. TR severity was determined using semi-quantitative approach including colour jet area, vena contracta width, density of continuous Doppler jet, hepatic vein flow pattern, trans-tricuspid inflow pattern, annular diameter, right ventricle, and right atrial size. Major comorbidities, re-admissions and all-cause mortality were extracted from the electronic health records. The final analysis included 33 305 patients with median follow-up period of 3.34 years (interquartile range 2.11-4.54). TR (≥mild) was present in 31% of our cohort. One-year mortality rates were 7.7% for patients with no/trivial TR, 16.8% for patients with mild TR, 29.5% for moderate TR, and 45.6% for patients with severe TR (P < 0.001). Univariate and multivariate analyses demonstrated a positive correlation between TR severity and overall mortality and rates of heart failure re-admission after adjustment for potential confounders. The proportional hazards method for overall mortality showed that patients with moderate [hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.02-1.3, P = 0.024] and severe TR (HR 1.43, 95% CI 1.08-1.88, P = 0.011) had a worse prognosis than those with no or minimal TR. CONCLUSIONS: The presence of any degree of TR is associated with adverse clinical outcome. At least moderate TR is independently associated with increased mortality. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Tricuspid regurgitation (TR) is a frequent echocardiographic finding; however, its effect on outcome is unclear. The objectives of current study were to evaluate the impact of TR severity on heart failure hospitalization and mortality. METHODS AND RESULTS: We retrospectively reviewed consecutive echocardiograms performed between 2011 and 2016 at the Tel-Aviv Medical Center. TR severity was determined using semi-quantitative approach including colour jet area, vena contracta width, density of continuous Doppler jet, hepatic vein flow pattern, trans-tricuspid inflow pattern, annular diameter, right ventricle, and right atrial size. Major comorbidities, re-admissions and all-cause mortality were extracted from the electronic health records. The final analysis included 33 305 patients with median follow-up period of 3.34 years (interquartile range 2.11-4.54). TR (≥mild) was present in 31% of our cohort. One-year mortality rates were 7.7% for patients with no/trivial TR, 16.8% for patients with mild TR, 29.5% for moderate TR, and 45.6% for patients with severe TR (P < 0.001). Univariate and multivariate analyses demonstrated a positive correlation between TR severity and overall mortality and rates of heart failure re-admission after adjustment for potential confounders. The proportional hazards method for overall mortality showed that patients with moderate [hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.02-1.3, P = 0.024] and severe TR (HR 1.43, 95% CI 1.08-1.88, P = 0.011) had a worse prognosis than those with no or minimal TR. CONCLUSIONS: The presence of any degree of TR is associated with adverse clinical outcome. At least moderate TR is independently associated with increased mortality. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Varius Dannenberg; Matthias Koschutnik; Carolina Donà; Christian Nitsche; Katharina Mascherbauer; Gregor Heitzinger; Kseniya Halavina; Andreas A Kammerlander; Georg Spinka; Max-Paul Winter; Martin Andreas; Markus Mach; Matthias Schneider; Anna Bartunek; Philipp E Bartko; Christian Hengstenberg; Julia Mascherbauer; Georg Goliasch Journal: Front Cardiovasc Med Date: 2022-06-02
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Andrzej Kleinrok; Łukasz Tułecki; Andrzej Kutarski Journal: Cardiovasc Diagn Ther Date: 2021-04
Authors: Simone Romano; Davide Dell'atti; Robert M Judd; Raymond J Kim; Jonathan W Weinsaft; Jiwon Kim; John F Heitner; Rebecca T Hahn; Afshin Farzaneh-Far Journal: JACC Cardiovasc Imaging Date: 2021-04-14
Authors: Sean Coffey; Ross Roberts-Thomson; Alex Brown; Jonathan Carapetis; Mao Chen; Maurice Enriquez-Sarano; Liesl Zühlke; Bernard D Prendergast Journal: Nat Rev Cardiol Date: 2021-06-25 Impact factor: 32.419