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Characteristics and outcomes of patients with tricuspid regurgitation and advanced heart failure.
Pagnesi, Matteo; Riccardi, Mauro; Chiarito, Mauro; Stolfo, Davide; Baldetti, Luca; Lombardi, Carlo Mario; Colombo, Giada; Inciardi, Riccardo Maria; Tomasoni, Daniela; Loiacono, Ferdinando; Maccallini, Marta; Villaschi, Alessandro; Gasparini, Gaia; Montella, Marco; Contessi, Stefano; Cocianni, Daniele; Perotto, Maria; Barone, Giuseppe; Merlo, Marco; Cappelletti, Alberto Maria; Sinagra, Gianfranco; Pini, Daniela; Metra, Marco; Adamo, Marianna.
Afiliação
  • Pagnesi M; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.
  • Riccardi M; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.
  • Chiarito M; Humanitas Research Hospital IRCCS, Rozzano-Milan.
  • Stolfo D; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.
  • Baldetti L; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.
  • Lombardi CM; Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Colombo G; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.
  • Inciardi RM; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.
  • Tomasoni D; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.
  • Loiacono F; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.
  • Maccallini M; Humanitas Research Hospital IRCCS, Rozzano-Milan.
  • Villaschi A; Humanitas Research Hospital IRCCS, Rozzano-Milan.
  • Gasparini G; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.
  • Montella M; Humanitas Research Hospital IRCCS, Rozzano-Milan.
  • Contessi S; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.
  • Cocianni D; Humanitas Research Hospital IRCCS, Rozzano-Milan.
  • Perotto M; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.
  • Barone G; Humanitas Research Hospital IRCCS, Rozzano-Milan.
  • Merlo M; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.
  • Cappelletti AM; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.
  • Sinagra G; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.
  • Pini D; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.
  • Metra M; Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Adamo M; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.
J Cardiovasc Med (Hagerstown) ; 25(3): 200-209, 2024 Mar 01.
Article em En | MEDLINE | ID: mdl-38251453
ABSTRACT

AIMS:

To evaluate the role of tricuspid regurgitation in advanced heart failure.

METHODS:

The multicenter observational HELP-HF registry enrolled consecutive patients with heart failure and at least one 'I NEED HELP' criterion evaluated at four Italian centers between January 2020 and November 2021. Patients with no data on tricuspid regurgitation and/or receiving tricuspid valve intervention during follow-up were excluded. The population was stratified by no/mild tricuspid regurgitation vs. moderate tricuspid regurgitation vs. severe tricuspid regurgitation. Variables independently associated with tricuspid regurgitation, as well as the association between tricuspid regurgitation and clinical outcomes were investigated. The primary outcome was all-cause mortality.

RESULTS:

Among the 1085 patients included in this study, 508 (46.8%) had no/mild tricuspid regurgitation, 373 (34.4%) had moderate tricuspid regurgitation and 204 (18.8%) had severe tricuspid regurgitation. History of atrial fibrillation, any prior valve surgery, high dose of furosemide, preserved left ventricular ejection fraction, moderate/severe mitral regurgitation and pulmonary hypertension were found to be independently associated with an increased likelihood of severe tricuspid regurgitation. Estimated rates of 1-year all-cause death were of 21.4, 24.5 and 37.1% in no/mild tricuspid regurgitation, moderate tricuspid regurgitation and severe tricuspid regurgitation, respectively (log-rank P  < 0.001). As compared with nonsevere tricuspid regurgitation, severe tricuspid regurgitation was independently associated with a higher risk of all-cause mortality (adjusted hazard ratio 1.38, 95% confidence interval 1.01-1.88, P  = 0.042), whereas moderate tricuspid regurgitation did not.

CONCLUSION:

In a contemporary, real-world cohort of patients with advanced heart failure, several clinical and echocardiographic characteristics are associated with an increased likelihood of severe tricuspid regurgitation. Patients with severe tricuspid regurgitation have an increased risk of mortality.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência da Valva Tricúspide / Insuficiência Cardíaca / Insuficiência da Valva Mitral Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Cardiovasc Med (Hagerstown) Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência da Valva Tricúspide / Insuficiência Cardíaca / Insuficiência da Valva Mitral Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Cardiovasc Med (Hagerstown) Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article