Abstract 15374: Tricuspid Annular Size and Prognosis of Moderate or Severe Tricuspid Regurgitation
Background: Moderate or severe functional tricuspid regurgitation (TR) is frequently encountered secondary to left-sided non-valvular disease or following valve surgery. Current guidelines recommend surgical correction of severe TR just at the time left valve surgery despite underlining tricuspid annulus (TA) size. This study tried to evaluate the prognostic impact of TA size on outcome of moderate or severe TR
Methods: From Jan 2005 to Dec 2014, patients with moderate or severe TR secondary to left-sided valve surgery, non-valvular disease, or isolated TR were retrospectively investigated. The cardiovascular outcomes were defined as a composite of hospitalization of heart failure, stroke, and cardiovascular (CV) death, and were assessed in relation to tertiles of TA size.
Results: Among a total of 200 patients (mean age 68 years, women 68%), the highest tertile group showed most frequency of left-sided valve surgery and the medical history of HF. The TA size was correlated with the severity of TR assigned as color Doppler grade and systolic diastolic tissue Doppler velocity of TA (T-s’). During an average follow-up of 5.3 years, there were 82 (40.1%) occurrences of primary outcomes, including 61 heart failures (30.5%), 12 CV deaths (6%), and 9 strokes (4.5%). Kaplan-Meier survival curve revealed high frequency of adverse CV outcomes in the highest tertile group. Multivariate analysis identified TA size and T-s’ as independent predictors of outcomes. Enlarged TA size was significantly associated with outcomes irrespective of the subgroup according to the etiology, severity of TR, and T-s’ (p=0.207, p=0.769, p=0.149 for interaction, respectively). On ROC curve analysis a TA size cut-off of 4.0 cm was beat for predicting adverse CV events.
Conclusion: This study shows that TA size should be considered for assessing the clinical prognosis of TR more than moderate severity.
Author Disclosures: H. Bae: None. H. Kim: Consultant/Advisory Board; Modest; firstname.lastname@example.org.
- © 2016 by American Heart Association, Inc.