Etiology of tricuspid regurgitation and mortality: a multicenter cohort study.

IF 3.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Jorge Rodríguez-Capitán, Paloma Márquez-Camas, Jesús Carmona-Carmona, Diego Félix Arroyo Moñino, Marinela Chaparro-Muñoz, Matías Soler-González, Manuel García Del Río, Teodora Egido de la Iglesia, Jorge Segovia-Reyes, Mora Murri, José Raúl López Salguero, David Couto-Mallón, Miguel Romero-Cuevas, Francisco Javier Pavón-Morón, Mario Gutiérrez-Bedmar, Manuel Jiménez-Navarro
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引用次数: 0

Abstract

Background: Significant tricuspid regurgitation (TR) encompasses a wide range of etiologies, complicating a comprehensive understanding of disease progression and prognostic factors. This study aimed to assess mortality associated with significant TR, focusing on the role of valvular disease etiology and other predictive factors.

Methods: This is a retrospective, multicenter, cohort observational study, including all consecutive patients with moderate-to-severe or greater TR. The patients were classified into five etiological groups: organic TR, TR secondary to left valvulopathy, TR secondary to left or right ventricular dysfunction, TR secondary to pulmonary hypertension, and atrial TR. The long-term mortality was assessed (median follow-up: 39.8 months).

Results: 757 patients were included. The overall mortality incidence rate was 162.5 deaths per 1000 patient-years. Compared to atrial TR, all other etiologies presented a higher mortality risk: organic TR adjusted hazard ratio (aHR) = 2.344 (95% confidence interval [CI]: 1.138-4.829), left valvulopathy-related TR aHR = 1.901 (95% CI: 1.011-3.574), ventricular dysfunction-related TR aHR = 3.683 (95% CI: 1.627-8.338), and pulmonary hypertension-related TR aHR = 2.446 (95% CI: 1.215-4.927). In addition to known factors, male sex was associated with a higher mortality risk (aHR = 1.608, 1.175-2.201), while beta-blocker use was linked to a lower risk (aHR = 0.674, 0.502-0.904).

Conclusions: In a large cohort of patients with significant TR, and after adjusting for clinical and echocardiographic variables, all etiological groups exhibited a higher mortality risk compared to atrial TR. Additionally, male patients with TR had a higher mortality risk, while beta-blocker therapy emerged as a protective factor.

三尖瓣反流和死亡率的病因学:一项多中心队列研究。
背景:显著三尖瓣反流(TR)包括广泛的病因,使对疾病进展和预后因素的全面理解复杂化。本研究旨在评估与显著TR相关的死亡率,重点关注瓣膜病病因和其他预测因素的作用。方法:本研究是一项回顾性、多中心、队列观察性研究,纳入所有中重度及以上TR的连续患者,将患者分为5组:器质性TR、继发于左心瓣膜病变的TR、继发于左或右心室功能障碍的TR、继发于肺动脉高压的TR和心房TR。评估长期死亡率(中位随访时间:39.8个月)。结果:共纳入757例患者。总死亡率为每1000例患者年162.5例死亡。与心房TR相比,所有其他病因的死亡率均较高:有机TR校正危险比(aHR) = 2.344(95%可信区间[CI]: 1.138-4.829),左瓣膜病相关的TR aHR = 1.901 (95% CI: 1.011-3.574),心室功能障碍相关的TR aHR = 3.683 (95% CI: 1.627-8.338),肺动脉高压相关的TR aHR = 2.446 (95% CI: 1.215-4.927)。除已知因素外,男性与较高的死亡风险相关(aHR = 1.608, 1.175-2.201),而使用受体阻滞剂与较低的风险相关(aHR = 0.674, 0.502-0.904)。结论:在大量有明显TR的患者队列中,在调整了临床和超声心动图变量后,所有病因组的死亡率都高于心房TR。此外,男性TR患者的死亡率更高,而受体阻滞剂治疗成为一种保护因素。
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
Clinical Research in Cardiology
Clinical Research in Cardiology 医学-心血管系统
CiteScore
11.40
自引率
4.00%
发文量
140
审稿时长
4-8 weeks
期刊介绍: Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
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