Right atrial reservoir strain <9.4% measured by 2D speckle-tracking echocardiography independently predicted mortality and heart failure hospitalizations in patients with severe TR.
Cohort (n=180)
Does right atrial function measured by 2D-STE predict mortality and heart failure hospitalizations in patients with at least severe tricuspid regurgitation?
Right atrial reservoir strain measured by 2D speckle-tracking echocardiography provides independent prognostic value for mortality and heart failure hospitalizations in patients with severe tricuspid regurgitation.
Abstract Aims The optimal management of severe tricuspid regurgitation (TR) remains controversial. While right ventricular systolic function is an established prognostic marker of outcomes, the potential role of right atrial (RA) function is unknown. This study aimed to describe RA function by 2D speckle-tracking echocardiography (STE) in at least severe TR and to evaluate its potential association with cardiovascular outcomes. Methods and results Consecutive patients with at least (≥) severe TR (severe, massive, or torrential TR) evaluated in the Heart Valve Clinic following a comprehensive clinical protocol were included. Consecutive control subjects and patients with permanent isolated atrial fibrillation (AF) were included for comparison (control and AF group, respectively). RA function was measured with 2D-STE and two components of RA function were calculated: reservoir (RASr) and contractile (RASct) strain (AutoStrain, Philips Medical Systems the EPIQ system). A combined endpoint of hospital admission due to heart failure (HF) or all-cause mortality was defined. Patients with ≥ severe TR (n = 140) showed lower RASr compared with controls (n = 20) and with the AF group (n = 20) (P 0.001). Atrial TR showed lower RASr compared with other aetiologies of TR (P 0.001). After a median follow-up of 2.2 years (IQR: 12–41 months), RASr remained an independent predictor of mortality and HF. A cut-off value of RASr of 9.4% held the best accuracy to predict outcomes. Conclusion RA function by 2D-STE independently predicts mortality and HF hospitalizations in patients with ≥ severe TR.
Hinojar et al. (Wed,) conducted a cohort in Severe tricuspid regurgitation (TR) (n=180). Right atrial function (reservoir strain) by 2D speckle-tracking echocardiography vs. Controls and patients with permanent isolated atrial fibrillation was evaluated on Combined endpoint of hospital admission due to heart failure (HF) or all-cause mortality. Right atrial reservoir strain <9.4% measured by 2D speckle-tracking echocardiography independently predicted mortality and heart failure hospitalizations in patients with severe TR.
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