In secondary tricuspid regurgitation, RAVCVOL >1.23 was significantly associated with increased risk of all-cause mortality or heart failure hospitalization (p<0.05).
Do right atrioventricular coupling (RAVC) and right atrial (RA) stiffness indices predict all-cause mortality or heart failure hospitalization in patients with secondary tricuspid regurgitation?
In patients with secondary tricuspid regurgitation, the echocardiographic ratio between right atrial volume and right ventricular stroke volume (RAVCVOL) is an independent predictor of mortality and heart failure hospitalization.
Absolute Event Rate: 0% vs 0%
Abstract Background and Aims In secondary tricuspid regurgitation (STR) patients, the clinical value of right atrioventricular coupling (RAVC) and right atrial (RA) stiffness indices has never been evaluated. Accordingly, we explored the association with a composite outcome of all-cause mortality or heart failure hospitalization of: 1) RAVC index obtained either with speckle tracking echocardiography (RAVCSTE) or as the ratio between RA volume (RAV) and right ventricular (RV) stroke volume (RAVCVOL), and 2) RA stiffness index calculated as the ratio between RAV index and RA longitudinal reservoir strain (RALS). Methods 513 patients with mild-to-severe STR (75±13 years, 58% severe) were included. Results After a mean follow-up of 18±15 months, 195 patients (38%) reached the composite endpoint. On spline curve modeling, the cut-off values associated with increased two-year event rates were: (1) 0.82 for RAVCSTE (reduced values of the ratio between RALS and RV free wall strain indicating impaired coupling, the RA not supporting effectively the RV filling, despite a good systolic function of the RV); (2) 1.23 for RAVCVOL (higher values suggesting greater RA remodeling relative to RV stroke volume and altered coupling); (3) 4.6 for RA stiffness index (higher values indicating a diminished RA compliance to filling). However, in multivariable Cox regression analyses and hierarchical χ2 analyses, only RAVCVOL maintained a significant association with the outcome (p0.05). Conclusions In STR patients, RAVC and RA stiffness indices are associated with the risk of events, with RAVCVOL yielding the strongest association.
Clément et al. (Thu,) reported a other. In secondary tricuspid regurgitation, RAVCVOL >1.23 was significantly associated with increased risk of all-cause mortality or heart failure hospitalization (p<0.05).