Valvular & structural heart disease
Determinants of Right Heart Hemodynamic Derangement in Patients With and Without Tricuspid Regurgitation
Authors' conclusion
SV index is related to TR severity, while the effect of TR on RA V wave is mediated by RA compliance. Respiratory-related changes in RA hemodynamics are associated with TR severity. The indirect Fick method overestimates cardiac index proportionally to TR severity.
Study context
- Population
- Patients with and without tricuspid regurgitation (TR)61% had moderate or severe TR
- Participants
- 74 patients
- Exposure
- Hemodynamic correlates of right atrial (RA) pressure and stroke volume (SV) across TR severity
- Outcome
- Right heart findings by TR severity
Methodological details3-dimensional echocardiography obtained simultaneously with direct Fick right heart catheterization
- 3-dimensional echocardiography obtained simultaneously with direct Fick right heart catheterization
Main finding
As reported in the abstract
- TR severity associated with larger right heart chambers, lower RA compliance, higher values and lower inspiratory decrease of RA pressure, and lower cardiac index
- P <0.01
Observational data: associations, not effects.
Further findings
Multivariable associations
| β (95% CI) | |
|---|---|
| RA V wave per 1/RA compliance strainMultivariable analysis | 2.1 (1.4–2.7) |
| SV index per RegFrMultivariable analysis | −97.6 (−120.1 to −75.0) |
| Outcome | β (95% CI) |
|---|---|
| Mediation of RegFr effect on V wave by ln-transformed RA compliance strainMediated effect | 13.9 (7.6–20.2) |
Univariate correlations
- RA V wave vs RegFr
- r =−0.57
- RA V wave vs ln-transformed RA compliance strain
- r =−0.74
- SV index vs RegFr
- r =−0.65
- Univariate analysis
Indirect Fick method cardiac index
- Indirect Fick method overestimated cardiac index proportionally to RegFr
- P < 0.01
Original publication
Determinants of Right Heart Hemodynamic Derangement in Patients With and Without Tricuspid Regurgitation. Circ Heart Fail. Published 2 July 2025. doi:10.
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