Characteristics and prognosis of patients with significant tricuspid regurgitation - 07/06/19
Résumé |
Introduction |
Severe tricuspid regurgitation (TR) usually remains asymptomatic for a long period, and the diagnosis is often delayed, at an advanced stage of right heart failure (RHF). Only a minority of patients are referred to surgery. We aim to describe the characteristics and prognosis according to aetiologies of patients with significant TR.
Method |
Two hundred and eight consecutive patients with moderate-to-severe (grade III) or severe (grade IV) TR were included from echocardiography reports between 2013 and 2017. Median follow-up was 18(6–38) months.
Results |
Patients (mean age 75 years, 46.6% males) were divided into 4 groups according to TR aetiology, group 1: primary TR (15.4%), group 2: TR secondary to left heart disease with a history of left heart valve surgery (24.5%), group 3: TR secondary to left heart disease with no history of left valvular surgery (26%) and group 4: idiopathic TR (34.1%). During follow-up, 61 patients (29%) experienced at least one decompensation of RHF requiring hospitalization. Only 11 patients (5.3%) underwent tricuspid valve surgery during follow-up with a perioperative mortality of 36%. The 4 years survival was much lower than the expected survival of age- and sex-matched individuals of the general population (56±4% vs. 74%). After adjustment for outcome predictors, patients with idiopathic TR had a higher risk of mortality (adjusted HR=1.83[1.05–3.21]; P=0.034) compared to other groups.
Conclusion |
Moderate-to-severe and severe TR is associated with a high-risk of hospitalization for RHF and death at 4 years and a low rate of surgery. (Fig. 1 Idiopathic TR is associated with worse outcome than other etiologies)
Le texte complet de cet article est disponible en PDF.Plan
Vol 11 - N° 3
P. e312-e313 - juin 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.