Leaflet Area as a Determinant of Tricuspid Regurgitation Severity in Patients With Pulmonary Hypertension
Key result
Tricuspid leaflet-to-closure area ratio <1.78 predicts ~69-fold higher risk of severe TR in PH.
- OR 68.7
- 95% CI 16.2-292.7
- n=255
Why the study?
The contribution of tricuspid leaflet adaptation to the pathophysiology and severity of tricuspid regurgitation in pulmonary hypertension patients was not previously examined.
Does tricuspid leaflet area determine tricuspid regurgitation severity in patients with pulmonary hypertension?
Study Design
Type
Cohort (n=255)
Multicenter
Yes
Structured PICO
Does tricuspid leaflet area determine tricuspid regurgitation severity in patients with pulmonary hypertension?
P
Population
255 patients with pulmonary hypertension from pre and postcapillary pathogeneses evaluated with 3-dimensional echocardiography.
E
Exposure
3-dimensional echocardiogram focused on the tricuspid apparatus to measure tricuspid leaflet area (TLA) and closure area.
C
Comparator
Normal controls, and internal comparison based on TLA:closure area ratio.
O
Outcome
Tricuspid regurgitation (TR) severity.surrogate
Main Result
Odds Ratio: 68.7 (95% CI 16.2–292.7)
In patients with pulmonary hypertension, an inadequate increase in tricuspid leaflet area relative to closure area is a strong predictor of severe functional tricuspid regurgitation.
Authors
Discussion
No takes yet. Share an insight, caveat, or question.
Implication
May aid tricuspid regurgitation assessment in pulmonary hypertension; hypothesis-generating and requires prospective validation before practice change.
Cite This Study
Afilalo et al. (2015) conducted a cohort in Pulmonary hypertension (n=255). Ratio of tricuspid leaflet area to closure area <1.78 vs. Adequate increase in tricuspid leaflet area (ratio ≥1.78) was evaluated on Severe tricuspid regurgitation (OR 68.7, 95% CI 16.2-292.7). A tricuspid leaflet area to closure area ratio <1.78 was highly predictive of severe tricuspid regurgitation in patients with pulmonary hypertension (OR 68.7; 95% CI 16.2-292.7).