Patients with severe tricuspid regurgitation may have adverse events in long run

A composite of hospitalization and all-cause death for heart failure (primary outcome) was assessed. Six hundred thirteen patients were enrolled (mean age 74±13 years), and during the median follow-up period of 26.5 months, 141 died, and 62 were hospitalized for heart failure.

The study revealed the following findings:

• The 5‐year event‐free rate was 60.1%. TR pressure gradient (adjusted hazard ratio [HR], 1.03), blood urea nitrogen (adjusted HR, 1.02), left atrial volume index (adjusted HR, 1.01), and serum albumin (adjusted HR, 0.56) were identified as independent predictors of adverse events.
• A risk model based on the four clinical factors that included elevated blood urea nitrogen levels (>25 mg/dL), pulmonary hypertension (TR pressure gradient >40 mm Hg), decreased albumin levels (<3.7 g/dL) and left atrial enlargement (left atrial volume index <34 mL/m2) revealed a graded increase in the risk of adverse events.

"The prognosis of isolated severe TR is not always favorable. In patients with isolated severe TR and concomitant risk factors, such as left atrial enlargement, liver or renal dysfunction, and pulmonary hypertension, careful attention should be paid," the researchers wrote in their study.

"Additional studies are needed to assess the impact of the interventions on clinical outcomes in patients with severe tricuspid regurgitation with concomitant risk factors," they concluded.

Reference:

Nishiura N, Kitai T, Okada T, Sano M, Miyawaki N, Kim K, Murai R, Toyota T, Sasaki Y, Ehara N, Kobori A, Kinoshita M, Koyama T, Furukawa Y. Long-Term Clinical Outcomes in Patients With Severe Tricuspid Regurgitation. J Am Heart Assoc. 2022 Dec 24:e025751. doi: 10.1161/JAHA.122.025751. Epub ahead of print. PMID: 36565178.