Heart failure & cardiomyopathiesCohort study
Interaction of secondary ventricular tricuspid regurgitation with right ventricular (RV) in HFREF: an invasive pressure-volume loop study
- retrospective analysis
- invasive pressure-volume loop study
Authors' conclusion
The vTR2/3 in context of HFrEF was independently associated with the presence of sMR, increased pulsatile loads, and a pronounced RV-PA uncoupling over almost the entire afterload range. Future studies will need to determine under which haemodynamic conditions a mechanical tricuspid regurgitation reduction in HFrEF patients is advisable.
Study context
- Population
- Heart failure with reduced ejection fraction (HFrEF) patients, with RV pressure-volume loop and Swan-Ganz catheter data integrated with RV/left ventricular (LV) imaging findings
- Participants
- 134 HFrEF patients
- Exposure
- vTR2/3 compared with vTR0/1
Main finding
As reported in the abstract
Parameters independently associated with the presence of vTR2/3
- presence of secondary mitral regurgitation (sMR), aOR
- 1.67
- presence of sMR, P
- P = .045
- lower PA compliance, aOR
- 0.43
- lower PA compliance, P
- P = .021
- PA compliance AUC
- 0.82
- PA compliance cut-off
- <2.24 ml/mmHg
- PA compliance AUC, P
- P < .001
- concomitant sMR2/3, aOR
- 4.56
- concomitant sMR2/3, P
- P = .012
- Ees/Ea ratio, aOR
- 0.024
- Ees/Ea ratio, P
- P = .005
- Ees/Ea AUC
- 0.84
- Ees/Ea cut-off
- <0.6
- Ees/Ea AUC, P
- P < .001
Observational data: associations, not effects.
Further findings
RV-PA uncoupling across total afterload range (Ea tertile)
- RV-PA uncoupling observed across the entire total afterload range; larger and more dysfunctional RV in vTR2/3 compared with vTR0/1, independent of the afterload
All-cause mortality
- RV-PA uncoupling and reduced PA compliance were independently associated with all-cause mortality
Original publication
Interaction of secondary ventricular tricuspid regurgitation with RV in HFREF: an invasive pressure-volume loop study. ESC Heart Fail. Published 11 May 2026. doi:10.1093/eschf/xvag134
Summarised from the published abstract; every number is checked against it