What question did this study set out to answer?

To determine the community-based prevalence, clinical characteristics, and prognostic implications of moderate or severe tricuspid regurgitation.

August 15, 2018JACC. Cardiovascular imaging

Burden of Tricuspid Regurgitation in Patients Diagnosed in the Community Setting

Q: What are the key findings of this study?

Isolated clinically significant tricuspid regurgitation was associated with higher mortality compared to matched cases with trivial TR (adjusted RR 1.68; 95% CI 1.04-2.60; P=0.03).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Tricuspid regurgitation (n=417). Intervention: Isolated clinically significant (≥moderate) tricuspid regurgitation vs. Matched cases with trivial tricuspid regurgitation. Primary outcome: Mortality (RR 1.68, 95% CI 1.04-2.60, p=0.03).

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Key result

Isolated clinically significant TR is linked to ~68% higher mortality versus trivial TR.

RR 1.68
95% CI 1.04-2.60
P=0.03
n=417

Why the study?

The prevalence, cause distribution, and clinical significance of tricuspid regurgitation in the community setting are mostly unknown.

Population

417 adult residents of Olmsted County diagnosed with moderate or greater TR by Doppler echocardiography

Comparison

Isolated TR versus trivial TR matched for age, sex, atrial fibrillation, ejection fraction, and comorbidity index

Design

Community-based cohort study

Authors

YTYan TopilskyCardiac Imaging SMSimon MaltaisHeart Failure & Transplant JMJosé R. Medina‐InojosaGeneral / Preventive / Lipids

Discussion

Member takes

Implication

Cohort study reveals increased mortality from clinically significant tricuspid regurgitation in community residents, highlighting an undertreated public health burden.

Key Points

To determine the community-based prevalence, clinical characteristics, and prognostic implications of moderate or severe tricuspid regurgitation.
Evaluated all adult residents of Olmsted County, Minnesota, who underwent clinically indicated Doppler echocardiography between 1990 and 2000 for moderate or greater tricuspid regurgitation.
Characterized isolated tricuspid regurgitation cases (lacking significant comorbidities, left-sided valve disease, or pulmonary hypertension) and evaluated survival against controls matched for age, sex, ejection fraction, atrial fibrillation, and comorbidity index.
Identified 417 residents with moderate or greater tricuspid regurgitation, yielding an age- and sex-adjusted prevalence of 0.55% (95% CI: 0.50% to 0.60%), which was higher in women (p < 0.01) and increased strongly with age (p < 0.0001).
Isolated tricuspid regurgitation accounted for 8.1% of cases and independently predicted higher mortality (adjusted RR: 1.68; 95% CI: 1.04 to 2.60; p = 0.03), showing significantly worse survival than matched controls with trivial regurgitation (p = 0.0014).
Only 2.6% of patients diagnosed with moderate or greater tricuspid regurgitation underwent tricuspid valve surgery during follow-up.

Study Design

Type

Cohort (n=417)

Multicenter

PICO

Population

417 adult residents of Olmsted County, Minnesota, diagnosed with clinically significant (≥moderate) tricuspid regurgitation by Doppler echocardiography between 1990 and 2000.

Exposure / Comparator

Isolated clinically significant (≥moderate) tricuspid regurgitation vs Matched cases with trivial tricuspid regurgitation

Primary Outcome

Mortality — RR 1.68 (1.04-2.60), p=0.03

Main Result

Relative Risk: 1.68 (95% CI 1.04–2.6)

p-value: p=0.03

Cite This Study

Topilsky et al. (2018) conducted a cohort in Tricuspid regurgitation (n=417). Isolated clinically significant (≥moderate) tricuspid regurgitation vs. Matched cases with trivial tricuspid regurgitation was evaluated on Mortality (RR 1.68, 95% CI 1.04-2.60, p=0.03). Isolated clinically significant tricuspid regurgitation was associated with higher mortality compared to matched cases with trivial TR (adjusted RR 1.68; 95% CI 1.04-2.60; P=0.03).

synapsesocial.com/papers/6aaa278acf2bca5c547e6ba3 https://doi.org/10.1016/j.jcmg.2018.06.014

Topics

Tricuspid regurgitation

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Implication

Cohort study reveals increased mortality from clinically significant tricuspid regurgitation in community residents, highlighting an undertreated public health burden.

Burden of Tricuspid Regurgitation in Patients Diagnosed in the Community Setting

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

Topics

Burden of Tricuspid Regurgitation in Patients Diagnosed in the Community Setting

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider