Prevalence & Natural History of Tricuspid Regurgitation in Ischemic Mitral Regurgitation Patients

BackgroundFunctional tricuspid regurgitation (FTR) is most often secondary to left-sided heart pathology involving the mitral valve. We studied the incidence, clinical impact, risk factors, and natural history of patients who developed FTR due to an ischemic cause of mitral regurgitation (IMR). We conducted a retrospective cohort study based on data collected from January 2012 to December 2014. Patients diagnosed with IMR were eligible for the study. The mean follow-up was five years.RESULTSThe study group consisted of 134 patients with IMR divided into two groups based on FTR development (FTR vs non-FTR group). Forty patients were diagnosed with FTR (30.1%). FTR patients were older (63.0 ± 10.4 vs 57.1 ± 11.0, respectively, p<0.05) with a high incidence of previous coronary artery disease (p<.006). Severe IMR, high pulmonary arterial pressure (PAP), and failed revascularization were significant predictors of FTR development (p<.001, p<.005, p<.003, respectively). Low systolic left ventricle function was a predictor for FTR progression.CONCLUSIONClinical observations showed that FTR development due to IMR is common. Elderly patients with ischemic heart disease are at particularly high risk. FTR incidence and severity are directly proportional to the severity of IMR. FTR tends to deteriorate in about one-fifth of IMR patients and is mainly affected by the left ventricular systolic function.