%0 Generic %A Montalto, Claudio %A Mangieri, Antonio %A Jabbour, Richard J. %A Pagnesi, Matteo %A Buzzatti, Nicola %A Leone, Pierpasquale %A Regazzoli, Damiano %A Ancona, Francesco %A Lanzillo, Giuseppe %A Giannini, Francesco %A Stella, Stefano %A De Bonis, Michele %A Alfieri, Ottavio %A Camici, Paolo G. %A Margonato, Alberto %A Colombo, Antonio %A Agricola, Eustachio %A Latib, Azeem %D 2019 %T Prevalence, Burden and Echocardiographic Features of Moderate to Severe Tricuspid Regurgitation: Insights from a Tertiary Referral Center %U https://tandf.figshare.com/articles/dataset/Prevalence_burden_and_echocardiographic_features_of_moderate_to_severe_tricuspid_regurgitation_insights_from_a_tertiary_referral_center/7543010 %R 10.6084/m9.figshare.7543010.v2 %2 https://tandf.figshare.com/ndownloader/files/14021099 %2 https://tandf.figshare.com/ndownloader/files/14021102 %2 https://tandf.figshare.com/ndownloader/files/14021105 %2 https://tandf.figshare.com/ndownloader/files/14021108 %K Echocardiography %K heart failure %K outcome %K right ventricle %K tricuspid regurgitation %K valvular regurgitation %X

Background: Although systematically underestimated in the past, the importance of tricuspid regurgitation (TR) is being progressively recognized. We aimed to evaluate the clinical significance of severe TR from a cohort of patients at a tertiary center.

Methods: A retrospective analysis was performed on 6309 consecutive patients undergoing echocardiography between October 2014 and September 2015 in a single center in Milan, Italy. The study endpoints included cardiovascular mortality, major adverse cardiac and cerebrovascular events (MACCE) and net adverse clinical events (NACE).

Results: A total of 2336 (37%) patients were found to have TR of any severity, 272 (4.3%) had severe TR, 415 (6.6%) moderate TR, and 1649 (26.1%) mild TR. In the severe TR group, 40 (14.7%) patients suffered cardiovascular death, while 53 (19.5%) and 141 (51.8%) developed MACCE and NACE, respectively. In addition, there were 88 (32.4%) patients with severe TR who were re-hospitalized for cardiovascular-related events. Patients with severe TR were more likely to be in New York Heart Association functional class III–IV (p = 0.022) and on higher doses of loop diuretic (p = 0.022) than those with only moderate TR. Multivariable analysis revealed that blood urea nitrogen (BUN, p = 0.031) and abnormal liver function blood tests (p = 0.010) were independent predictors of mid-term cardiovascular mortality, while BUN and tricuspid annular plane systolic excursion were found to be independent predictors of mid-term NACE.

Conclusions: The prevalence of any TR was high in patients undergoing echocardiography at a tertiary referral center, and severe TR was not uncommon and associated with high mid-term morbidity and mortality.

%I Taylor & Francis