Valvular & structural heart diseaseDiagnostic or prognostic study
Tricuspid Anatomic Regurgitant Orifice Area by Cardiac Computed Tomography
- Prognostic cohort study
- 4 Allina Health centers
Authors' conclusion
This first outcome study of patients with clinically significant TR examined by 4D-CTA shows that higher AROA measurement strongly associates with worse right heart remodeling and independently associates with excess mortality.
Study context
- Population
- Patients with clinically significant tricuspid regurgitation (TR) evaluated for TR intervention, 2019–2023Anatomic regurgitant orifice area (AROA) measured
- Participants
- 174 patients
- Comparison
- Tricuspid AROA ≥1.1 cm² vs <1.1 cm² by 4D-CTA
- Outcome
- All-cause mortality under medical management after diagnosis
Performance
All-cause mortality under medical management
Adjusted hazard ratio
2.23
95% CI 1.02–4.85
P = 0.040
AROA ≥1.1 cm² vs AROA <1.1 cm²
adjusted HR 2.23 (95% CI 1.02–4.85); P = 0.040
As reported in the abstract
- Worse 3-year survival under medical management with AROA ≥1.1 cm²: 68% [Q1-Q3: 56%-82%] vs 36% [Q1-Q3: 28%-52%]
- P = 0.013
Further findings
Mortality in whole cohort · median follow-up 2.3 years [Q1-Q3: 1.1-3.2 years]
- Died under medical management
- 49 (28%)
- 3-year survival rate
- 55% [Q1-Q3: 45%-67%]
Right heart remodeling
- AROA ≥1.1 cm²: higher TRI-SCOREs, larger tricuspid annulus, coaptation gap, RV and right atrial volumes
- all P < 0.001
- AROA ≥1.1 cm²: similar RV EF but lower RV free-wall longitudinal strain
- P < 0.001
Original publication
Tricuspid Anatomic Regurgitant Orifice Area by Cardiac Computed Tomography. JACC Cardiovasc Imaging. Published 28 October 2025. doi:10.1016/j.jcmg.2025.08.021
Summarised from the published abstract; every number is checked against it