Development of significant tricuspid regurgitation over time and prognostic implications: new insights into natural history
| Autor: | Pieter van der Bijl, Rachid Abou, Edgard A. Prihadi, Martin B. Leon, Nina Ajmone Marsan, Jeroen J. Bax, Erhan Gursoy, E. Mara Vollema, Gregg W. Stone, Victoria Delgado, Rebecca T. Hahn |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Heart disease Natural history Tricuspid regurgitation 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Tricuspid Valve Insufficiency Internal medicine medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over business.industry Hazard ratio Retrospective cohort study Odds ratio Middle Aged medicine.disease Prognosis Confidence interval Log-rank test Echocardiography Concomitant Cardiology Disease Progression Female Cardiology and Cardiovascular Medicine business Progression rate |
| Zdroj: | European Heart Journal, 39(39), 3574-3581 |
| ISSN: | 1522-9645 3574-3581 |
| Popis: | Aims To evaluate the risk factors influencing the development of significant (moderate and severe) tricuspid regurgitation (TR), and its impact on all-cause mortality in large registry of referral centre. Methods and results In 1000 patients (mean age 68 ± 13 years; 50.9% male) with documented significant TR, clinical, and echocardiographic data were retrospectively analysed when the echocardiogram showed none/mild TR. Patients with congenital heart disease were excluded. The study population was divided into quartiles according to the time interval between the two echocardiograms: Group 1: ≤1.2 years, n = 251; Group 2: 1.3–4.7 years, n = 248, Group 3: 4.8–8.9 years, n = 251; Group 4: ≥9.0 years, n = 250. Baseline age [odds ratio (OR) 1.02], presence of pacemaker and defibrillator lead (OR 1.59), presence of mild (vs. none) TR (OR 8.96), reduced tricuspid annulus plane systolic excursion (OR 0.86), and tricuspid annulus dilation (OR 1.06) were independently associated with development of significant TR in a short period of time. Any valvular surgery (without concomitant tricuspid surgery) occurring between both echocardiograms was also associated with a higher risk of fast development of significant TR (OR 1.58). During a median follow-up of 2.9 years after the second echocardiogram (with significant TR), 42.1% patients died. Patients with fast development of significant TR showed worse survival than patients with slower significant TR development (log rank P = 0.001). Fast development of significant TR was independently associated with all-cause mortality (hazard ratio per preceding year of development: 0.92, confidence interval 0.90–0.94; P Conclusion By identifying patients at increased risk of developing significant TR, close echocardiographic surveillance can be indicated permitting effective therapy at an earlier stage to improve survival. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|