Beniamino Rosario Pagliaro, Pier Pasquale Leone, Alessandro Villaschi, Francesca Pugno Vanoni, Matteo Biroli, Ferdinando Loiacono, Marta Pellegrino, Giuseppe Pinto, Marta Maccallini, Matteo Pagnesi, Giuliana Cimino, Laura Lupi, Damiano Regazzoli Lancini, Renato Maria Bragato, Giulio Stefanini, Bernhard Reimers, Daniela Pini, Marco Metra, Gianluigi Condorelli, Marianna Adamo, Antonio Mangieri, Antonio Colombo
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引用次数: 0
Abstract
Background: Renal dysfunction (RD) is common in patients with heart failure (HF), however its impact on clinical outcomes in patients with tricuspid regurgitation (TR) and HF is still debated; therefore, we aimed to assess the impact of RD on clinical outcomes in this population.
Methods: All patients with HF and a prevalent or incident diagnosis of TR presenting at two centers between January 2020 and July 2021 were enrolled, in both acute (in-hospitalized patients) and chronic settings (outpatient). Patients were stratified according to the degree of RD (Group 1 <30 mL/min (n = 70), Group 2 30-59 mL/min (n = 123) and Group 3 ≥60 mL/min (n = 56).
Results: Out of 249 patients, those with severe RD had lower left ventricular ejection fraction (41.8 ± 13.1% vs. 45.7 ± 14.2% vs. 48.6 ± 13.1%, p = 0.020) and tricuspid annular plane systolic excursion (16.6 ± 3.7 mm vs. 17.6 ± 4.0 mm vs. 20.0 ± 4.4 mm, p < 0.001) while brain natriuretic peptides levels were higher (979 ± 1514 pg/mL vs. 490 ± 332 pg/mL vs. 458 ± 543 pg/mL, p = 0.049) than in the other subgroups. After a median follow-up of 279 (interquartile range, IQR 195-481) days, all-cause mortality was higher in patients with severe RD (37.7% vs. 23.3% vs. 13.7%, p = 0.012). HF hospitalizations (32.7% vs. 31.2% vs. 30.6%, p = 0.970) and the composite of all-cause mortality or HF hospitalization (54.1% vs. 47.9% vs. 42.0%, p = 0.444) did not differ between subgroups.
Conclusions: Severe RD is highly present in patients with HF and TR and is associated with increased incidence of all-cause mortality.
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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