Association of Tricuspid Regurgitation With Outcome in Acute Heart Failure
Circulation: Cardiovascular Imaging, ISSN: 1942-0080, Vol: 16, Issue: 7, Page: 566-576
2023
- 11Citations
- 19Captures
- 1Mentions
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Metrics Details
- Citations11
- Citation Indexes11
- 11
- CrossRef3
- Captures19
- Readers19
- 19
- Mentions1
- News Mentions1
- News1
Most Recent News
Study Findings from Azienda Sanitaria Universitaria Provide New Insights into Right Ventricular Dysfunction (Association of Tricuspid Regurgitation With Outcome in Acute Heart Failure)
2023 JUL 19 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Cardiovascular Daily -- Investigators publish new report on right ventricular dysfunction. According
Article Description
BACKGROUND: Tricuspid regurgitation (TR) is common in chronic heart failure (HF) and is associated with negative prognosis. However, evidence on prognostic implications of TR in acute HF is lacking. We sought to investigate the association between TR and mortality and the interaction with pulmonary hypertension (PH) in patients admitted for acute HF. METHODS: We enrolled 1176 consecutive patients with a primary diagnosis of acute HF and with available noninvasive estimation of TR and pulmonary arterial systolic pressure. RESULTS: Moderate-severe TR was present in 352 patients (29.9%) and was associated with older age and more comorbidities. The prevalence of PH (ie, pulmonary arterial systolic pressure >40 mm Hg), right ventricular dysfunction, and mitral regurgitation was higher in moderate-severe TR. At 1 year, 184 (15.6%) patients died. Moderate-severe TR was associated with higher 1-year mortality risk after adjustment for other echocardiographic parameters (pulmonary arterial systolic pressure, left ventricle ejection fraction, right ventricular dysfunction, mitral regurgitation, left and right atrial indexed volumes; hazard ratio, 1.718; P=0.009), and the association with outcome was maintained when clinical variables (eg, natriuretic peptides, serum creatinine and urea, systolic blood pressure, atrial fibrillation) were added to the multivariable model (hazard ratio, 1.761; P=0.024). The association between moderate-severe TR and outcome was consistent in patients with versus without PH, with versus without right ventricular dysfunction, and with versus without left ventricle ejection fraction <50%. Patients with coexistent moderate-severe TR and PH had 3-fold higher 1-year mortality risk compared with patients with no TR or PH (hazard ratio, 3.024; P<0.001). CONCLUSIONS: In patients hospitalized for acute HF, the severity of TR is associated with 1-year survival, regardless of the presence of PH. The coexistence of moderate-severe TR and estimated PH was associated with a further increase in mortality risk. Our data must be interpreted in the context of potential underestimation of pulmonary arterial systolic pressure in patients with severe TR.
Bibliographic Details
Ovid Technologies (Wolters Kluwer Health)
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