Isolated Tricuspid Regurgitation and Long-Term Outcome in Patients With Preserved Ejection Fraction.

Yuta Seko, Takao Kato, Masayuki Shiba, Yusuke Morita, Yuhei Yamaji, Yoshizumi Haruna, Eisaku Nakane, Tetsuya Haruna, Moriaki Inoko
Author Information
  1. Yuta Seko: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine Kyoto Japan.
  2. Takao Kato: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine Kyoto Japan.
  3. Masayuki Shiba: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine Kyoto Japan.
  4. Yusuke Morita: Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
  5. Yuhei Yamaji: Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
  6. Yoshizumi Haruna: Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
  7. Eisaku Nakane: Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
  8. Tetsuya Haruna: Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
  9. Moriaki Inoko: Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.

Abstract

The aim of this study was to evaluate the association of isolated tricuspid regurgitation (TR) with long-term outcome in patients with preserved left ventricular ejection fraction (LVEF). We retrospectively analyzed 3,714 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding severe and moderate left-side valvular disease and LVEF <50%. We classified patients into 2 groups: moderate to severe TR (n=53) and no moderate to severe TR (n=3,661). Next, we generated a propensity score (PS)-matched cohort: the moderate to severe TR group and the no moderate to severe TR group (n=41 in each group). The primary outcome was a composite of all-cause death and major adverse cardiac events. In the moderate to severe TR group, patients were older, and more likely to have higher left atrial volume index and E/e' than those in the no moderate to severe TR group. In the PS-matched cohort, cumulative 3-year incidence of the primary outcome was 61.5% in the moderate to severe TR group and 24.3% in the no moderate to severe TR group (log-rank P=0.043; hazard ratio, 2.86; 95% CI: 1.37-6.37). Isolated moderate to severe TR is associated with poor clinical outcome in patients with preserved LVEF.

Keywords

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