Valvular & structural heart diseaseCohort study
Prevalence, Incidence, and Outcomes of Diastolic Dysfunction in Isolated Tricuspid Regurgitation
- Retrospective cohort study
- propensity-score matched (3:1)
Authors' conclusion
Diastolic dysfunction, increased heart failure with preserved ejection fraction probability, and impaired left atrial strain are commonly present in patients with idiopathic FTR, suggesting that the latter may not be truly isolated. Patients with FTR without DD or heart failure are at increased risk of incident DD. Patients with FTR and DD display worse outcomes.
Study context
- Population
- Adults without structural heart disease, by idiopathic functional tricuspid regurgitation (FTR)
- Participants
- 30,428 adults
- Exposure
- Degrees of functional TR
- Outcome
- Prevalence, incidence and outcome of LV diastolic dysfunction (DD)
Main finding
As reported in the abstract
Prevalence of severe DD (≥3 of 4 abnormal parameters)
Prevalence of severe DD (≥3 of 4 abnormal parameters)
≥ moderate DD
- Trend across FTR grades
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident DD, ≥ moderate vs no FTR · median 3.0 years — ≥ moderate FTR vs No FTR · incident severe DD · confirmed in patients without lung disease or RV enlargement | 8.45 (2.60–27.50) | |
| Incident DD, ≥ moderate vs no FTR · median 3.0 years — ≥ moderate FTR vs No FTR · incident ≥ moderate DD · confirmed in patients without lung disease or RV enlargement | 2.82 (1.40–5.69) | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | No FTR | Mild | Moderate | Severe | Estimate |
|---|---|---|---|---|---|
| HFpEF probability (H2FPEF score) | median 29.7% | median 45.5% | median 61.4% | median 88.7% | |
| Impaired left atrial strain <24% | Not reported in the abstract | 35% | 48% | 69% |
Adverse outcomes · median 5.0 years
- ≥ moderate FTR with diastolic dysfunction (DD) had the greatest risk of worse outcomes
- multivariable P < 0.001
- Association between TR and adverse outcomes significantly diminished in the absence of DD
Original publication
Prevalence, Incidence, and Outcomes of Diastolic Dysfunction in Isolated Tricuspid Regurgitation. JACC Cardiovasc Imaging. Published 24 July 2024. doi:10.1016/j.jcmg.2024.05.019
Summarised from the published abstract; every number is checked against it