Natural history of isolated functional tricuspid regurgitation

• DOI: 10.1016/j.acvd.2024.10.142
• Publication Date: 2025-01-15T21:42:27Z
• Authors: P. Vanhaecke; C. Tribouilloy; Y. Bohbot; J. Dreyfus; T. Le Tourneau; Y. Lavie-Badie; C. Selton-Suty; A. Coisne
• Keywords: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; 610

International audience ; IntroductionIsolated functional tricuspid regurgitation (Is-FTR), characterized by the absence of organic, left-sided or pulmonary hypertension causes, is relatively common. Recent consensus documents affirmed considerable gaps in knowledge regarding its natural history and outcome.ObjectiveIn view of advanced age of affected patients, intrinsic outcome implications warrant defining its associated risk of excess-mortality compared with the general population.MethodThe main endpoint was survival under conservative management and patients who underwent tricuspid transcatheter/surgical treatment during follow-up were censored at procedure date. The cohort included 715 consecutive patients with median follow-up of 22 months. Each patient with Is-FTR was matched to all individuals with the same birth year and sex in France to estimate expected-survival, using French life-tables.ResultsThe main baseline characteristics of the study population (75 ± 12 years, 61.5% women) are in line with previous reports (Table 1). During follow-up, 175 deaths (24.4%) occurred, of which 92 (52.5%) were cardiovascular. Survival rates of patients with ≥ moderate-to-severe Is-FTR were lower than expected survival rates: 85 ± 1% vs. 93% at one-year and 57 ± 3% vs. 71% at five-years (RS: 80%) (Fig. 1). This reduction in 5-year survival compared to expected was observed in all strata of the population, for both men (52 ± 5% vs. 69%, RS: 75%) and women (60 ± 4% vs. 72%, RS:83%), in patients with Charlson comorbidity-index ≤ 2 (66 ± 5% vs. 75%, RS: 88%) or > 2 (50 ± 4% vs. 68%, RS: 73%), in atrial fibrillation (54 ± 4% vs. 69%, RS: 78%) or in sinus rhythm (64 ± 6% vs. 92%, RS: 78%), with right-ventricular dysfunction (43 ± 4% vs. 71%, RS: 60%) or without right-ventricular dysfunction (66 ± 4% vs. 71%, RS: 93%), and with severe TR (52 ± 4% vs. 71%, RS: 73%) or moderate-to-severe TR (62 ± 5% vs. 72%, RS: 86%). Using a robust estimation of standard errors in the Cox model, after adjustment to age, sex, Charlson index, ...