Clinical Impact of Renal Dysfunction in Patients with Severe Tricuspid Regurgitation and Chronic Heart Failure.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2025-03-05 eCollection Date: 2025-03-01 DOI:10.31083/RCM26080

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.

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重度三尖瓣反流合并慢性心力衰竭患者肾功能不全的临床影响。

背景：肾功能不全（RD）在心力衰竭（HF）患者中很常见，但其对三尖瓣反流（TR）和心力衰竭患者临床结局的影响仍存在争议；因此，我们的目的是评估RD对该人群临床结果的影响。方法：纳入2020年1月至2021年7月期间在两个中心就诊的所有HF和普遍或偶然诊断为TR的患者，包括急性（住院患者）和慢性（门诊患者）。患者分层根据程度的RD(组1结果:249名患者,那些严重的RD左心室射血分数较低(41.8±13.1%和45.7±14.2%和48.6±13.1%,p = 0.020)和三尖瓣环平面收缩偏差(16.6±3.7毫米和17.6±4.0毫米和20.0±4.4毫米,p < 0.001),而脑利钠肽水平较高(979±1514 pg / mL vs 490±332 pg / mL vs 458±543 pg / mL, p = 0.049)比其他的子组。中位随访279天（四分位间距，IQR 195-481）后，严重RD患者的全因死亡率更高（37.7% vs. 23.3% vs. 13.7%, p = 0.012）。HF住院率（32.7% vs. 31.2% vs. 30.6%, p = 0.970）和全因死亡率或HF住院率（54.1% vs. 47.9% vs. 42.0%, p = 0.444）在亚组间无差异。结论：严重RD在HF和TR患者中高度存在，并与全因死亡率增加相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

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.