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Chronic Ovine Model of Right Ventricular Failure and Functional Tricuspid Regurgitation
Published on: March 17, 2023
798
Contemporary Etiologies, Outcomes, and Novel Risk Score for Isolated Tricuspid Regurgitation
Tom Kai Ming Wang1, Kevser Akyuz1, Amgad Mentias1
1Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
JACC. Cardiovascular Imaging
|December 19, 2021
Summary
Secondary tricuspid regurgitation (TR) is common and linked to worse survival, though not in adjusted analyses. A new risk score helps predict mortality in these patients.
Area of Science:
- Cardiology
- Echocardiography
- Clinical Epidemiology
Background:
- Isolated tricuspid regurgitation (TR) presents a significant clinical challenge due to its varied causes and frequent poor outcomes.
- Limited recent research exists on the epidemiology of isolated TR.
Purpose of the Study:
- To investigate the etiologies and outcomes of isolated tricuspid regurgitation (TR) in a large contemporary patient cohort.
- To develop and validate a risk model for predicting mortality in patients with isolated TR.
Main Methods:
- A cohort of 9,045 patients with moderate to severe isolated TR (2004-2018) was analyzed.
- TR etiologies were classified as primary or secondary.
- All-cause mortality was the primary endpoint; a risk model for 1-year mortality was developed and validated.
Main Results:
- Secondary TR (94.8%) was far more common than primary TR (5.2%).
- Major secondary causes included left heart disease (54.4%), atrial functional (24.3%), and pulmonary disease (17.0%).
- Overall mortality was 44.0% over a mean follow-up of 2.6 years. Secondary TR showed worse survival in unadjusted but not multivariable analyses.
Conclusions:
- Secondary TR is the predominant etiology in significant isolated TR.
- A novel risk score effectively stratifies 1-year mortality risk, potentially aiding clinical management decisions for high-risk patients.
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