Valvular & structural heart disease
Atrial Functional Tricuspid Regurgitation: Contemporary Characteristics, Outcomes, and Novel Risk Score
Authors' conclusion
Patients with AF-TR had poor prognosis especially if tricuspid regurgitation effective regurgitant orifice area was ≥0.40 cm2, validating the guidelines threshold for severe tricuspid regurgitation. A novel risk score for 1-year mortality in patients with AF-TR was developed, offering potential utility for risk stratification and treatment guidance; however, external validation is needed.
Study context
- Population
- Consecutive patients with at least moderate-to-severe atrial functional tricuspid regurgitation (AF-TR) seen between January 2004 and December 2018patients with AF-TR (mean age 73.9 ± 15.0 years, 82.2% female, mean follow-up 4.1 ± 3.6 years)
- Participants
- 370 patientsEvents: 81 (21.9%)
- Predictors
- Right heart failure, serum albumin, right atrial volume indexed, tricuspid annular plane systolic excursion/right ventricular systolic pressure ratio, and TR-effective regurgitant orifice area
- Predicted outcome
- 1-year all-cause mortality
Methodological detailsconsecutive patients, univariable and multivariable logistic regression
- Consecutive patients
- Univariable and multivariable logistic regression
Model performance
As reported in the abstract
Area under the curve
Risk model discrimination
0.87
- Derived model; external validation is needed
Further findings
Median survival by AF-TR effective regurgitant orifice area
Independent associations with 1-year mortality (multivariable)
| OR (95% CI) | ||
|---|---|---|
| Right heart failure | 2.40 (1.31–4.41) | |
| Serum albumin (lower) | 0.88 (0.85–0.92) | |
| Right atrial volume indexed (higher) | 1.25 (1.04–1.49) | |
| Tricuspid annular plane systolic excursion/right ventricular systolic pressure ratio (lower) | 0.82 (0.70–0.95) | |
| TR-effective regurgitant orifice area (higher) | 1.11 (1.02–1.21) | |
| 0.20.5125Odds ratio (log scale) |
Total mortality · mean follow-up 4.1 ± 3.6 years
- Total mortality
- 219 (59.2%)
Original publication
Atrial Functional Tricuspid Regurgitation: Contemporary Characteristics, Outcomes, and Novel Risk Score. JACC Adv. Published 25 February 2025. doi:10.
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