Excess Mortality Associated With Functional Tricuspid Regurgitation Complicating Heart Failure With Reduced Ejection Fraction
Key result
Severe FTR in HFrEF is linked to ~50% lower 5-year survival versus trivial cases.
Why the study?
Functional tricuspid regurgitation is common in heart failure with reduced ejection fraction, but its intrinsic clinical implications are not fully understood.
Does functional tricuspid regurgitation severity increase mortality in patients with heart failure with reduced ejection fraction?
Population
13 026 patients with heart failure stage B-C and ejection fraction<50%
Comparison
Higher FTR degree vs trivial tricuspid regurgitation
Design
Cohort study
Follow-up
5-year
Authors
Discussion
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Member takes
Implication
Severe functional tricuspid regurgitation warrants attention in HFrEF; extends prior associations yet leaves open whether correction improves outcomes.
Structured PICO
Does functional tricuspid regurgitation severity increase mortality in patients with heart failure with reduced ejection fraction?
P
Population
13,026 patients from Mayo Clinic (2003-2011) diagnosed with heart failure stage B-C and ejection fraction <50%, with FTR grading and systolic pulmonary artery pressure estimation by Doppler echocardiography. Excluded: pacemakers/defibrillators, organic valve disease, or previous valve surgery. Mean age 68±14 years, 35% women.
I
Intervention
Higher severity of functional tricuspid regurgitation (mild, moderate, or severe)
C
Comparator
Trivial functional tricuspid regurgitation
O
Outcome
Overall mortality (censored at implantation of a defibrillator, ventricular assist device, or cardiac transplantation)hard clinical
In patients with heart failure with reduced ejection fraction, increasing severity of functional tricuspid regurgitation is independently associated with considerably worse long-term survival.
Cite This Study
Benfari et al. (2019) studied this question. In patients with heart failure and reduced ejection fraction, severe functional tricuspid regurgitation is associated with a 5-year survival of 34% compared to 68% for trivial cases.