Background
Severe functional tricuspid regurgitation (fTR) is associated with adverse clinical
outcomes and remains under-treated. There is recent interest in this disease due to
emerging tricuspid valve therapies. However, the timing and selection of patients
who may benefit from treatment is uncertain. Risk factors associated with mortality
after diagnosis of severe fTR may help guide treatment.
Aim
We studied patients with severe fTR to assess predictors of mortality.
Methods
We retrospectively identified consecutive patients who had severe fTR diagnosed on
transthoracic echocardiography in a single academic tertiary hospital. These were
categorised into atrial fibrillation (AF)– and non-AF–related groups. Patient characteristics
and echocardiographic parameters were collected. We then analysed the collected parameters
on their impact on occurrence of mortality and also on the time to mortality.
Results
A total of 635 patients with severe fTR were studied (41.6 % male, mean age of 68.6±15.4
yrs). There were 130 (20.5%) in the AF-related group and 505 (79.5%) in the non-AF
related-group. Median follow-up duration was 774 days, during which 154 (24.3%) deaths
occurred within the first year. Older age on diagnosis, reduced left ventricular ejection
fraction (LVEF) (<50%), high pulmonary systolic pressure (PASP) (>50 mmHg) and a prior
history of heart failure admissions were associated with occurrence of mortality.
Older age on diagnosis, reduced LVEF, and high PASP were also found to be associated
with time to mortality.
Conclusions
For patients diagnosed with severe fTR, advanced age on diagnosis, prior heart failure
admission, LVEF <50%, and PASP >50 mmHg are associated with mortality. These factors
could form the basis of future studies that determine the timing and decision to intervene
in patients with severe fTR.
Key Words
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Article info
Publication history
Published online: June 03, 2022
Accepted:
April 12,
2022
Received in revised form:
April 2,
2022
Received:
November 20,
2021
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
