What question did this study set out to answer?

This study aims to evaluate the impact of significant tricuspid regurgitation (TR) on mortality after left heart valve procedure.

June 25, 2026Journal of the American College of Cardiology

Right Ventricular Dysfunction, But Not Tricuspid Regurgitation, Is Associated With Outcome Late After Left Heart Valve Procedure

Q: What are the key findings of this study?

Right ventricular dysfunction, but not significant tricuspid regurgitation, was independently associated with mortality late after left heart valve procedures (22% overall mortality).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Previous left heart valve procedure (n=539). Intervention: Significant tricuspid regurgitation and right ventricular dysfunction vs. Absence of significant TR or RV dysfunction. Primary outcome: Mortality (p=<0.001).

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Key result

RV dysfunction, not significant TR, is linked to late mortality after left heart valve procedures.

P<0.001
n=539

Why the study?

Significant tricuspid regurgitation late after left heart valve procedures is frequent and surgical correction carries significant mortality risk, but the impact of tricuspid regurgitation on survival remains unclear.

Does significant tricuspid regurgitation or right ventricular dysfunction independently impact survival late after left heart valve procedures?

Population

539 consecutive patients with previous left heart valve procedure

Comparison

Significant tricuspid regurgitation vs without significant tricuspid regurgitation

Design

Prospective cohort study

Follow-up

53 ± 15 months

Authors

AKAndreas A. KammerlanderCardiac Imaging BMBeatrice A. MarzlufOtto Wagner Hospital AGAlexandra GráfStatistics Austria

Discussion

Member takes

Implication

RV dysfunction, not TR, independently predicted mortality after left heart valve surgery; leaves open whether TR correction improves survival.

Key Points

This study aims to evaluate the impact of significant tricuspid regurgitation (TR) on mortality after left heart valve procedure.
539 patients with previous left heart valve procedure were followed for an average of 53 months.
Tricuspid regurgitation was classified as moderate or greater severity based on echocardiography.
Kaplan-Meier and multivariable Cox analyses were performed to assess survival outcomes.
17% of patients exhibited significant tricuspid regurgitation.
Overall survival was worse in patients with TR (log-rank p < 0.001), but TR was not significantly linked to mortality per Cox analysis.
Right ventricular fractional area change was significantly lower in patients with TR (43% vs. 47%, p < 0.001).

Study Design

Type

Cohort (n=539)

Structured PICO

Does significant tricuspid regurgitation or right ventricular dysfunction independently impact survival late after left heart valve procedures?

Population

539 consecutive patients with a previous left heart valve procedure, prospectively followed for 53 ± 15 months.

Exposure

Presence of significant tricuspid regurgitation (moderate or greater severity by echocardiography) and right ventricular dysfunction

Comparator

Absence of significant tricuspid regurgitation and preserved right ventricular function

Outcome

Overall survival/mortalityhard clinical

Main Result

p-value: p=<0.001

Right ventricular dysfunction, rather than the presence of significant tricuspid regurgitation itself, is the independent driver of late mortality after left heart valve procedures.

Cite This Study

Kammerlander et al. (2014) conducted a cohort in Previous left heart valve procedure (n=539). Significant tricuspid regurgitation and right ventricular dysfunction vs. Absence of significant TR or RV dysfunction was evaluated on Mortality (p=<0.001). Right ventricular dysfunction, but not significant tricuspid regurgitation, was independently associated with mortality late after left heart valve procedures (22% overall mortality).

synapsesocial.com/papers/6a3cf28cb20054bd7fc0be0d https://doi.org/10.1016/j.jacc.2014.09.062

Topics

Tricuspid regurgitation Echocardiography

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Implication

RV dysfunction, not TR, independently predicted mortality after left heart valve surgery; leaves open whether TR correction improves survival.

Right Ventricular Dysfunction, But Not Tricuspid Regurgitation, Is Associated With Outcome Late After Left Heart Valve Procedure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Right Ventricular Dysfunction, But Not Tricuspid Regurgitation, Is Associated With Outcome Late After Left Heart Valve Procedure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

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