학술논문
Characteristics and outcomes of patients with tricuspid regurgitation and advanced heart failure.
Document Type
Academic Journal
Author
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.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.; Stolfo D; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.; Baldetti L; Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Lombardi CM; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.; 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; Humanitas Research Hospital IRCCS, Rozzano-Milan.; Maccallini M; Humanitas Research Hospital IRCCS, Rozzano-Milan.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.; Villaschi A; Humanitas Research Hospital IRCCS, Rozzano-Milan.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.; Gasparini G; Humanitas Research Hospital IRCCS, Rozzano-Milan.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.; Montella M; Humanitas Research Hospital IRCCS, Rozzano-Milan.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan.; Contessi S; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.; Cocianni D; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.; Perotto M; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.; Barone G; Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Merlo M; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.; Cappelletti AM; Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Sinagra G; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.; Pini D; Humanitas Research Hospital IRCCS, Rozzano-Milan.; Metra M; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.; Adamo M; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological sciences and Public Health, University of Brescia, Brescia.
Source
Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101259752 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1558-2035 (Electronic) Linking ISSN: 15582027 NLM ISO Abbreviation: J Cardiovasc Med (Hagerstown) Subsets: MEDLINE
Subject
Language
English
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.
(Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)
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.
(Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)