Valvular & structural heart diseaseCohort study

Characteristics, Determinants, and Prognostic Impact of Severe Tricuspid Regurgitation in Patients with Atrial Functional Mitral Regurgitation: Insights from the REVEAL-AFMR Registry

Eur J Heart FailPublished

  • Registry-based cohort study
  • multicentre (26 facilities in Japan)

Authors' conclusion

Severe TR coexisting with AFMR was common and was associated with increased event rates.

Study context

Population
Patients with significant atrial functional MR (moderate or severe functional MR with dilated left atrium and preserved LV function), Japan
Participants
792 patients
Exposure
Severe tricuspid regurgitation (TR) vs non-severe TR
  • Severe TRn = 118
Outcome
Composite of:
  • HF hospitalization
  • All-cause mortality

Main finding

HF hospitalization and all-cause mortality

Adjusted hazard ratio

1.65

95% CI 1.09–2.47

P = 0.017

Severe TR vs Non-severe TR
adjusted HR 1.65 (95% CI 1.09–2.47); P = 0.017

As reported in the abstract

Observational data: associations, not effects.

Secondary outcomes

Outcomeadjusted HR (95% CI)P value
All-cause mortality1.80 (1.06–3.06)P = 0.029

Prevalence of severe TR

Overall
14.9%
In severe atrial functional mitral regurgitation (AFMR)
34.6%

Independent determinants of severe TR

Age >75 years, permanent AF, chronic obstructive pulmonary disease, higher right atrial pressure

Atrial vs ventricular functional TR

Share of significant TR: atrial functional TR
41%
Share of significant TR: ventricular functional TR
59%
Similar prognosis despite more advanced right heart remodelling in ventricular TR

Original publication

Characteristics, Determinants, and Prognostic Impact of Severe Tricuspid Regurgitation in Patients with Atrial Functional Mitral Regurgitation: Insights from the REVEAL-AFMR Registry. Eur J Heart Fail. Published 19 February 2025. doi:10.1002/ejhf.3624

Summarised from the published abstract; every number is checked against it