Determinants of Tricuspid Regurgitation Progression and Its Implications for Adequate Management.

Autor:	Arteagoitia Bolumburu A; Department of Cardiology, Centro de Investigación Biomédica En Red: Enfemerdades Cardiovasculares University Hospital Ramon y Cajal, Madrid, Spain., Monteagudo Ruiz JM; Department of Cardiology, Centro de Investigación Biomédica En Red: Enfemerdades Cardiovasculares University Hospital Ramon y Cajal, Madrid, Spain., Mahia P; Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain., Pérez David E; Department of Cardiology, University Hospital La Paz, Madrid, Spain., González T; Department of Cardiology, Hospital Vall d'Hebrón, Barcelona, Spain., Sitges M; Barcelona Hospital Clinic de Barcelona, Barcelona, Spain., Li CH; Department of Cardiology, Hospital of Santa Creu I Sant Pau, Barcelona, Spain., Alonso D; Department of Cardiology, Hospital of Leon, León, Spain., Carrasco F; Department of Cardiology, Centro de Investigación Biomédica En Red: Enfemerdades Cardiovasculares Hospital Universitario Virgen de la Victoria, Málaga, Spain., Luna Morales M; Department of Cardiology, Centro de Investigación Biomédica En Red: Enfemerdades Cardiovasculares Hospital Universitario Virgen de la Victoria, Málaga, Spain., Adeba A; Department of Cardiology, University Hospital Central de Asturias, Oviedo, Spain., de la Hera JM; Department of Cardiology, University Hospital Central de Asturias, Oviedo, Spain., Zamorano JL; Department of Cardiology, Centro de Investigación Biomédica En Red: Enfemerdades Cardiovasculares University Hospital Ramon y Cajal, Madrid, Spain; Department of Cardiology, La Zarzuela Hospital, Madrid, Spain. Electronic address: zamorano@secardiologia.es.
Jazyk:	angličtina
Zdroj:	JACC. Cardiovascular imaging [JACC Cardiovasc Imaging] 2024 Jun; Vol. 17 (6), pp. 579-591. Date of Electronic Publication: 2023 Dec 06.
DOI:	10.1016/j.jcmg.2023.10.006
Abstrakt:	Background: Tricuspid regurgitation (TR) is associated with an increased mortality. Previous studies have analyzed predictors of TR progression and the clinical impact of baseline TR. However, there is a lack of evidence regarding the natural history of TR: the pattern of change and clinical impact of progression. Objectives: The authors sought to evaluate predictors of TR progression and assess the prognostic impact of TR progression. Methods: A total of 1,843 patients with at least moderate TR were prospectively followed up with consecutive echocardiographic studies and/or clinical evaluation. All patients with less than a 2-year follow-up were excluded. Clinical and echocardiographic features, hospitalizations for heart failure, and cardiovascular death and interventions were recorded to assess their impact in TR progression. Results: At a median 2.3-year follow-up, 19% of patients experienced progression. Patients with baseline moderate TR presented a rate progression of 4.9%, 10.1%, and 24.8% 1 year, 2 years, and 3 years, respectively. Older age (HR: 1.03), lower body mass index (HR: 0.95), chronic kidney disease (HR: 1.55), worse NYHA functional class (HR: 1.52), and right ventricle dilation (HR: 1.33) were independently associated with TR progression. TR progression was associated with an increase in chamber dilation as well as a decrease in ventriculoarterial coupling and in left ventricle ejection fraction (P < 0.001). TR progression was associated with an increased cardiovascular mortality and hospitalizations for heart failure (P < 0.001). Conclusions: Marked individual variability in TR progression hindered accurate follow-up. In addition, TR progression was a determinant for survival regardless of initial TR severity. Competing Interests: Funding Support and Author Disclosures This study was supported by the Instituto de Salud Carlos III, PI20/01206. Dr Sitges has received consulting and lecture fees from General Electric, Canon Medical, Medtronic, Edwards Lifesciences, and Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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