Prevalence and predictive factors for clinical outcomes of isolated functional tricuspid regurgitation

医学 内科学 心脏病学 射血分数 肾功能 心力衰竭 不利影响 病因学
作者
Shoko Nakagawa,Hiroyuki Takahama,Keiji Hoshino,Yoshiki Yanagi,Yuki Irie,Kenji Moriuchi,Masashi Amano,Atsushi Okada,Makoto Amaki,Hideaki Kanzaki,Kengo Kusano,Teruo Noguchi,Satoshi Yasuda,Chisato Izumi
出处
期刊:Journal of Cardiology [Elsevier BV]
卷期号:82 (1): 8-15 被引量:2
标识
DOI:10.1016/j.jjcc.2022.12.008
摘要

Background A substantial number of patients have functional tricuspid regurgitation (TR). Isolated functional TR has been undertreated and may be a next target for transcatheter intervention. However, the prevalence, patient characteristics, and predictive factors for prognosis remain unclear. Methods From patients in our echocardiographic database (N = 64,242), we extracted those with severe TR and examined prognosis according to etiologies of TR. Thereafter, we focused on two types of isolated functional TR; progressive TR after left-sided valve surgery (postoperative TR) and TR associated with annular dilatation (atrial TR). Composite adverse events were defined as all-cause death or hospitalization for heart failure (HF). Results Of 1001 patients with severe TR (median age, 77 years; female, 58 %), 71 (7 %) patients were classified as postoperative TR, and 149 (15 %) as atrial TR. During the follow-up period (median, 1.6 years), 30 composite adverse events were observed (postoperative TR, n = 14; atrial TR, n = 16). Composite adverse events were less frequent in these two types of functional TR than TR of other etiologies. Multivariate analysis adjusted for age and sex showed that a history of hospitalization for HF, history of cardiac surgery >2 times, loop diuretics, estimated glomerular filtration rate, blood urea nitrogen, hemoglobin, platelet level, left ventricular ejection fraction, and right ventricular dimension were associated with clinical adverse events (p < 0.05), while B-type natriuretic peptide level was not. Conclusions A considerable number of patients had isolated functional TR. Extracardiac factors such as renal function, hemoglobin and platelet are important in determining clinical outcomes.
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