Yohann Bohbot1, Gagandeep Chadha2, Justine Delabre2, Thomas Landemaine2, Christophe Beyls2, Christophe Tribouilloy3. 1. Department of Cardiology, Amiens University Hospital, avenue René-Laënnec, 80054, Amiens cedex 1, France; EA 7517, MP3CV, Jules Verne University of Picardie, chemin du Thil, 80054, Amiens cedex, France. 2. Department of Cardiology, Amiens University Hospital, avenue René-Laënnec, 80054, Amiens cedex 1, France. 3. Department of Cardiology, Amiens University Hospital, avenue René-Laënnec, 80054, Amiens cedex 1, France; EA 7517, MP3CV, Jules Verne University of Picardie, chemin du Thil, 80054, Amiens cedex, France. Electronic address: tribouilloy.christophe@chu-amiens.fr.
Abstract
BACKGROUND: Severe tricuspid regurgitation (TR) usually remains asymptomatic for a long period, and the diagnosis is often delayed until an advanced stage of right heart failure (RHF). Only a minority of patients are referred for surgery. AIM: To describe the characteristics and prognosis of patients with significant TR, according to aetiology. METHOD: Two-hundred and eight consecutive patients with moderate-to-severe (grade III) or severe (grade IV) TR were included from echocardiography reports between 2013 and 2017. Median follow-up was 18 (6-38) months. RESULTS: Patients (mean age 75 years; 46.6% men) were divided into four groups according to TR aetiology: group 1, primary TR (14.9%); group 2, TR secondary to left heart disease with a history of left heart valve surgery (24.5%); group 3, TR secondary to left heart or pulmonary disease with no history of left valvular surgery (26.5%); and group 4, idiopathic TR (34.1%). During follow-up, 61 patients (29.3%) experienced at least one episode of RHF decompensation requiring hospitalization. Only 11 patients (5.3%) underwent tricuspid valve surgery during follow-up. The 4-year survival was much lower than the expected survival of age- and sex-matched individuals in the general population (56±4% vs. 74%). After adjustment for outcome predictors, patients with idiopathic TR had a higher risk of mortality (adjusted hazard ratio 1.83, 95% confidence interval 1.05-3.21; P=0.034) compared with other groups. CONCLUSIONS: Moderate-to-severe or severe TR is associated with a high risk of hospitalization for RHF and death at 4 years, and a low rate of surgery. Idiopathic TR is associated with worse outcome than other aetiologies.
BACKGROUND: Severe tricuspid regurgitation (TR) usually remains asymptomatic for a long period, and the diagnosis is often delayed until an advanced stage of right heart failure (RHF). Only a minority of patients are referred for surgery. AIM: To describe the characteristics and prognosis of patients with significant TR, according to aetiology. METHOD: Two-hundred and eight consecutive patients with moderate-to-severe (grade III) or severe (grade IV) TR were included from echocardiography reports between 2013 and 2017. Median follow-up was 18 (6-38) months. RESULTS:Patients (mean age 75 years; 46.6% men) were divided into four groups according to TR aetiology: group 1, primary TR (14.9%); group 2, TR secondary to left heart disease with a history of left heart valve surgery (24.5%); group 3, TR secondary to left heart or pulmonary disease with no history of left valvular surgery (26.5%); and group 4, idiopathic TR (34.1%). During follow-up, 61 patients (29.3%) experienced at least one episode of RHF decompensation requiring hospitalization. Only 11 patients (5.3%) underwent tricuspid valve surgery during follow-up. The 4-year survival was much lower than the expected survival of age- and sex-matched individuals in the general population (56±4% vs. 74%). After adjustment for outcome predictors, patients with idiopathic TR had a higher risk of mortality (adjusted hazard ratio 1.83, 95% confidence interval 1.05-3.21; P=0.034) compared with other groups. CONCLUSIONS: Moderate-to-severe or severe TR is associated with a high risk of hospitalization for RHF and death at 4 years, and a low rate of surgery. Idiopathic TR is associated with worse outcome than other aetiologies.
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: Maciej Kubala; Christian de Chillou; Yohann Bohbot; Patrizio Lancellotti; Maurice Enriquez-Sarano; Christophe Tribouilloy Journal: Front Cardiovasc Med Date: 2022-02-15
Authors: Susanne Anna Schlossbauer; Francesco Fulvio Faletra; Vera Lucia Paiocchi; Laura Anna Leo; Giorgio Franciosi; Michela Bonanni; Gianmarco Angelini; Anna Giulia Pavon; Enrico Ferrari; Siew Yen Ho; Rebecca T Hahn Journal: J Cardiovasc Dev Dis Date: 2021-09-03