Moderate or greater tricuspid regurgitation in patients undergoing TAVI was associated with increased all-cause death (HR 2.11; 95% CI 1.19-3.77; P=0.011) and cardiovascular death.
Cohort (n=678)
No
Does concomitant significant tricuspid regurgitation and right ventricular dysfunction increase mortality in patients with severe aortic stenosis undergoing TAVI?
In patients undergoing TAVI, concomitant significant tricuspid regurgitation and right ventricular dysfunction are independent predictors of cardiovascular death, with ventricular functional TR having the worst survival outcomes.
Effect estimate: HR 2.11 (95% CI 1.19-3.77)
p-value: p=0.011
BACKGROUND: This study investigated the impact and predictive factors of concomitant significant tricuspid regurgitation (TR) and evaluated the roles of right ventricle (RV) function and the etiology of TR in the clinical outcomes of patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We assessed grading of TR severity, TR etiology, and RV function in pre- and post-TAVI transthoracic echocardiograms for 678 patients at Keio University School of Medicine. TR etiology was divided into 3 groups: primary TR, ventricular functional TR (FTR), and atrial FTR. The primary outcomes were all-cause and cardiovascular death. At baseline, moderate or greater TR was found in 55 (8%) patients and, after adjustment for comorbidities, was associated with increased all-cause death (hazard ratio HR 2.11; 95% confidence interval CI 1.19-3.77; P=0.011) and cardiovascular death (HR 2.29; 95% CI 1.06-4.99; P=0.036). RV dysfunction (RVD) also remained an independent predictor of cardiovascular death (HR 2.06; 95% CI 1.03-4.14; P=0.042). Among the TR etiology groups, patients with ventricular FTR had the lowest survival rate (P<0.001). Patients with persistent RVD after TAVI had a higher risk of cardiovascular death than those with a normal or recovered RV function (P<0.001). CONCLUSIONS: The etiology of TR and RV function play an important role in predicting outcomes in concomitant TR patients undergoing TAVI.
Jongh et al. (Wed,) conducted a cohort in Severe aortic stenosis (n=678). Moderate or greater tricuspid regurgitation vs. Less than moderate tricuspid regurgitation was evaluated on All-cause death (HR 2.11, 95% CI 1.19-3.77, p=0.011). Moderate or greater tricuspid regurgitation in patients undergoing TAVI was associated with increased all-cause death (HR 2.11; 95% CI 1.19-3.77; P=0.011) and cardiovascular death.