Stages III-IV of a modified right heart failure staging were independently associated with increased cardiovascular mortality (HR 2.01; 95% CI 1.27-3.18; p=0.003) in patients with severe TR.
Cohort (n=1,247)
Yes
Does a modified right heart failure staging (RHFS) and TR severity classification predict heart failure hospitalization and cardiovascular mortality in patients with severe tricuspid regurgitation?
A modified right heart failure staging system and advanced TR severity grading effectively stratify 1-year risk of cardiovascular mortality and heart failure hospitalization in patients with severe tricuspid regurgitation.
Hazard Ratio: 2.01 (95% CI 1.27–3.18)
p-value: p=0.003
Abstract Aims Severe tricuspid regurgitation (STR) is associated with adverse outcomes. This nationwide registry describes the prevalence, etiology, clinical and echocardiographic profile of STR using contemporary classifications, and evaluates the prognostic impact of a modified right heart failure staging (RHFS). Methods We prospectively enrolled consecutive patients with STR from 48 centers over 6 months and followed them for one year. TR severity (severe, massive, torrential) and etiology were defined using current recommendations. A modified RHFS incorporating RV remodeling and systolic dysfunction was applied. Results We included 1247 patients (mean age 76.7 ± 10.5 years; 70.2% women): 64.9% had severe TR, 24.1% massive TR, and 11.0% torrential TR. V-STR due to left-heart disease was the most frequent etiology (49.9%), followed by A-STR (19.8%). During follow-up, HF hospitalization occurred in 20.8%, cardiovascular death in 9.2%, and 12.3% underwent tricuspid intervention. In multivariable analysis, stages III–IV of the modified RHFS were independently associated with HF hospitalization (HR 1.58; 95% CI 1.13–2.23; p=0.008) and cardiovascular mortality (HR 2.01; 95% CI 1.27–3.18; p=0.003). Massive (HR 1.72; 95% CI 1.02–2.91; p=0.041) and torrential TR (HR 2.57; 95% CI 1.24–5.34; p=0.011) were also associated with cardiovascular mortality. Conclusions Massive and torrential TR identify patients at highest risk. The modified RHFS stratifies patients with STR into prognostic categories and may help guide timing of intervention.
Polo et al. (Wed,) conducted a cohort in Severe tricuspid regurgitation (n=1,247). Stages III-IV of a modified right heart failure staging (RHFS) vs. Lower RHFS stages was evaluated on Cardiovascular mortality (HR 2.01, 95% CI 1.27-3.18, p=0.003). Stages III-IV of a modified right heart failure staging were independently associated with increased cardiovascular mortality (HR 2.01; 95% CI 1.27-3.18; p=0.003) in patients with severe TR.