Valvular & structural heart diseaseCohort study
Quantitative Identification of High-Risk Tricuspid Regurgitation by Cardiac Magnetic Resonance
- Retrospective cohort study
- observational
Authors' conclusion
In this large cohort, CMR provided several markers of high risk among patients with TR, with TRF thresholds considered by current guidelines as "moderate" TR already associated with worse long-term prognosis.
Study context
- Population
- Patients with tricuspid regurgitation (TR) referred to clinical cardiac magnetic resonance (CMR), 2019–2024, with TR quantification (tricuspid regurgitant fraction (TRF)) and liver mapping (liver extracellular volume (L-ECV))371 with liver mapping data
- Participants
- 489 patients
- Exposure
- TRF severity categories by CMR
- Outcome
- All-cause mortality and HF hospitalization under medical management, accounting for timing of tricuspid intervention
- Follow-up
- Median 2.3 years
Main finding
As reported in the abstract
Survival free from both outcomes inversely associated with increasing TRF severity
P<0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | P value |
|---|---|
| TRF ≥20% with L-ECV ≥32% vs TRF ≥20% with L-ECV <32% — TRF ≥20% and L-ECV ≥32% vs TRF ≥20% and L-ECV <32% · primary outcome; highest adverse event rate | P < 0.001 |
| TRF ≥20% with L-ECV ≥32% vs TRF ≥20% with L-ECV <32% — TRF ≥20% and L-ECV ≥32% vs TRF ≥20% and L-ECV <32% · secondary outcome (all-cause mortality) | P = 0.012 |
Baseline TRF
- Median TRF 21% (IQR 14%-33%)
L-ECV ≥32% (liver mapping subset)
- L-ECV ≥32% associated with right-sided HF manifestations and long-term adverse outcomes, incremental prognostic value
- all P<0.001
- 371 with liver mapping data
Original publication
Quantitative Identification of High-Risk Tricuspid Regurgitation by Cardiac Magnetic Resonance. Circulation. Published 12 November 2025. doi:10.1161/circulationaha.125.074862
Summarised from the published abstract; every number is checked against it