Association of Tricuspid Regurgitation With Outcome in Acute Heart Failure.

التفاصيل البيبلوغرافية
العنوان:	Association of Tricuspid Regurgitation With Outcome in Acute Heart Failure.
المؤلفون:	Cocianni D; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Stolfo D; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.).; Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden (D.S.)., Perotto M; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Contessi S; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Barbisan D; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Savonitto G; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Rizzi JG; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Barbati G; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Merlo M; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Altinier A; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.)., Sinagra G; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy (D.C., D.S. M.P., S.C., D.B., G.S., J.G.R., G.B., M.M., A.A., G.S.).
المصدر:	Circulation. Cardiovascular imaging [Circ Cardiovasc Imaging] 2023 Jul; Vol. 16 (7), pp. 566-576. Date of Electronic Publication: 2023 Jun 29.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101479935 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1942-0080 (Electronic) Linking ISSN: 19419651 NLM ISO Abbreviation: Circ Cardiovasc Imaging Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Hagerstown, MD Lippincott Williams & Wilkins
مواضيع طبية MeSH:	Tricuspid Valve Insufficiency/diagnosis , Hypertension, Pulmonary/diagnostic imaging , Hypertension, Pulmonary/epidemiology , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Insufficiency/epidemiology , Mitral Valve Insufficiency/complications , Ventricular Dysfunction, Right* , Heart Failure/diagnostic imaging , Heart Failure/epidemiology , Heart Failure*/complications, Humans ; Retrospective Studies
مستخلص:	Background: Tricuspid regurgitation (TR) is common in chronic heart failure (HF) and is associated with negative prognosis. However, evidence on prognostic implications of TR in acute HF is lacking. We sought to investigate the association between TR and mortality and the interaction with pulmonary hypertension (PH) in patients admitted for acute HF. Methods: We enrolled 1176 consecutive patients with a primary diagnosis of acute HF and with available noninvasive estimation of TR and pulmonary arterial systolic pressure. Results: Moderate-severe TR was present in 352 patients (29.9%) and was associated with older age and more comorbidities. The prevalence of PH (ie, pulmonary arterial systolic pressure >40 mm Hg), right ventricular dysfunction, and mitral regurgitation was higher in moderate-severe TR. At 1 year, 184 (15.6%) patients died. Moderate-severe TR was associated with higher 1-year mortality risk after adjustment for other echocardiographic parameters (pulmonary arterial systolic pressure, left ventricle ejection fraction, right ventricular dysfunction, mitral regurgitation, left and right atrial indexed volumes; hazard ratio, 1.718; P =0.009), and the association with outcome was maintained when clinical variables (eg, natriuretic peptides, serum creatinine and urea, systolic blood pressure, atrial fibrillation) were added to the multivariable model (hazard ratio, 1.761; P =0.024). The association between moderate-severe TR and outcome was consistent in patients with versus without PH, with versus without right ventricular dysfunction, and with versus without left ventricle ejection fraction <50%. Patients with coexistent moderate-severe TR and PH had 3-fold higher 1-year mortality risk compared with patients with no TR or PH (hazard ratio, 3.024; P <0.001). Conclusions: In patients hospitalized for acute HF, the severity of TR is associated with 1-year survival, regardless of the presence of PH. The coexistence of moderate-severe TR and estimated PH was associated with a further increase in mortality risk. Our data must be interpreted in the context of potential underestimation of pulmonary arterial systolic pressure in patients with severe TR. Competing Interests: Disclosures Dr Stolfo reports personal fees from Novartis, Merck, GSK, and Acceleron outside the submitted work. Dr Merlo reports consultant and unrestricted fees at congresses, congress fees from Novartis and Vifor Pharma. Dr Sinagra reports consulting fees from Novartis, Impulse Dynamics and Biotronik, and speaker and honoraria from Novartis, Bayer, Astrazeneca, Boston Scientific, Vifor Pharma, Menarini and Akcea Therapeutics outside the submitted work. The other authors report no conflicts
التعليقات:	Comment in: Circ Cardiovasc Imaging. 2023 Jul;16(7):577-579. (PMID: 37381911)
فهرسة مساهمة:	Keywords: heart failure; pulmonary hypertension; tricuspid valve; tricuspid valve insufficiency; ventricular dysfunction
تواريخ الأحداث:	Date Created: 20230629 Date Completed: 20230721 Latest Revision: 20230723
رمز التحديث:	20240628
DOI:	10.1161/CIRCIMAGING.122.014988
PMID:	37381900
قاعدة البيانات:	MEDLINE

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تدمد:	1942-0080
DOI:	10.1161/CIRCIMAGING.122.014988