Comparison of Survival in Patients With Clinically Significant Tricuspid Regurgitation With and Without Heart Failure (From the Optum Integrated File)

Barker, Colin M.; Cork, David P.; McCullough, Peter A.; Mehta, Hirsch; Houten, Joanna Van; Gunnarsson, Candace; Ryan, Michael P.; Irish, William; Mollenkopf, Sarah; Verta, Patrick

doi:10.1016/j.amjcard.2020.12.070

Cited by 5 publications

(1 citation statement)

References 19 publications

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“…Analysis of contemporary big data shows that the effect of TR is marginal regarding mortality but has a significant negative effect on quality of life and is a tremendous healthcare burden in terms of cost and utilization of resources. [1][2][3][4] There are three types of TR, each with different etiologies: primary, secondary, and cardiac electric implantable device-related (CEID). 5 Primary TR is congenital or acquired and occurs when there is a problem with the tricuspid valve itself, such as Ebstein's anomaly, damage from infection, carcinoid, or trauma.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Tricuspid Interventions: Past, Present, and Future

Barker¹,

Goel

2023

Methodist DeBakey Cardiovascular Journal

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Tricuspid regurgitation (TR) etiologies include primary valve pathology or secondary (functional) regurgitation from increased hemodynamic pressure or volume on the right side of the heart. Patients with severe TR have a worse prognosis independent of all other variables. Surgical treatment for TR has mostly been limited to patients undergoing concomitant left-sided cardiac surgery. The results and durability of surgical repair or replacement are not well defined. For patients with significant and symptomatic TR, transcatheter techniques would be beneficial, but these techniques and devices have been slow to develop. Much of the delay is a result of neglect and challenges in defining the symptoms associated with TR. In addition, the anatomic and physiological aspects of the tricuspid valve apparatus present unique challenges. Several devices and techniques are in various phases of clinical investigation. This review highlights the current landscape of transcatheter tricuspid interventions and future opportunities. It is imminent that these therapies become commercially available and widely adopted to have a significant positive impact on millions of patients that have been neglected.

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Section: Introductionmentioning

confidence: 99%

Transcatheter Tricuspid Interventions: Past, Present, and Future

Barker¹,

Goel

2023

Methodist DeBakey Cardiovascular Journal

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Dynamic evolution of tricuspid regurgitation during hospitalization in patients with acute decompensated heart failure

Zocca,

Cocianni,

Barbisan

et al. 2024

European J of Heart Fail

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AimsSecondary tricuspid regurgitation (TR) is associated with poor prognosis in acute decompensated heart failure (ADHF). However, its dynamic evolution in response to volume status and treatment has never been previously investigated. In this study, we sought to explore the in‐hospital evolution of TR in ADHF patients and to assess its prognostic implications.Methods and resultsWe retrospectively enrolled patients admitted for ADHF with ≥2 in‐hospital echocardiographic evaluations of TR. Patients were categorized, according to TR evolution, into persistent moderate‐severe TR, improved TR (from moderate‐severe to trivial‐mild) and persistent trivial‐mild TR. The primary endpoint was a composite of 5‐year all‐cause mortality and heart failure hospitalization (HFH). A total of 1054 patients were included. Of 318 patients (30%) with moderate‐severe TR at admission, 49% improved TR severity and showed better trends of decongestion, whereas those who maintained persistent moderate‐severe TR had characteristics of more severe heart failure at admission and discharge. Atrial fibrillation, previous heart failure and higher dosage of loop diuretics before admission were associated with a lower probability of improved TR. After adjustment, improved TR was associated with lower risk of 5‐year all‐cause mortality/HFH compared with persistent moderate‐severe TR (hazard ratio [HR] 0.524, p = 0.008) and no different from persistent trivial‐mild TR (HR 0.878, p = 0.575). Results were consistent across all subgroups of in‐hospital variation of mitral regurgitation.ConclusionAmong ADHF patients with moderate‐severe TR at admission, 49% had an in‐hospital improvement in TR severity, which was associated with a reduction in risk of 5‐year all‐cause mortality and morbidity outcomes.

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