Valvular & structural heart disease
Characteristics, Determinants, and Prognostic Impact of Severe Tricuspid Regurgitation in Patients with Atrial Functional Mitral Regurgitation: Insights from the REVEAL-AFMR Registry
Main finding · HF hospitalization and all-cause mortalityResult — go to the resultAdjusted hazard ratio 1.65 95% CI 1.09–2.47Authors' 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
Methodological detailsmulticentre (26 facilities in Japan)
- Multicentre (26 facilities in Japan)
Main finding
HF hospitalization and all-cause mortality
Adjusted hazard ratio
1.65
95% CI 1.09–2.47
P = 0.017
Severe TRvs 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
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality | 1.80 (1.06–3.06) | P = 0.029 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
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.
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