Tricuspid Regurgitation and Mortality Risk Across Left Ventricular Systolic Function in Acute Heart Failure
Background:Tricuspid regurgitation (TR) is a common echocardiographic finding that has been related to adverse outcome under various clinical scenarios. Nevertheless, evidence supporting its prognostic value in heart failure (HF) is scarce, and, in most cases, contradictory. We evaluated the associa...
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| Veröffentlicht in: | Circulation Journal 2015/06/25, Vol.79(7), pp.1526-1533 |
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| creator | Santas, Enrique Chorro, Francisco Javier Miñana, Gema Méndez, José Muñoz, Jaime Escribano, David García-Blas, Sergio Valero, Ernesto Bodí, Vicent Núñez, Eduardo Sanchis, Juan Núñez, Julio |
| description | Background:Tricuspid regurgitation (TR) is a common echocardiographic finding that has been related to adverse outcome under various clinical scenarios. Nevertheless, evidence supporting its prognostic value in heart failure (HF) is scarce, and, in most cases, contradictory. We evaluated the association of TR grade with 1-year all-cause mortality in acute HF (AHF).Methods and Results:We included 1,842 consecutive patients admitted for AHF. Mean age was 72.8±11.3 years, 51% were female and 45.5% had LVEF |
| doi_str_mv | 10.1253/circj.CJ-15-0129 |
| format | Article |
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Nevertheless, evidence supporting its prognostic value in heart failure (HF) is scarce, and, in most cases, contradictory. We evaluated the association of TR grade with 1-year all-cause mortality in acute HF (AHF).Methods and Results:We included 1,842 consecutive patients admitted for AHF. Mean age was 72.8±11.3 years, 51% were female and 45.5% had LVEF <50%. The severity of TR was graded in non-TR, mild (1), moderate (2), moderate-severe (3) and severe (4). At 1-year follow-up, 370 patients (20.1%) had died. In patients with LVEF ≥50%, a significant and positive association between TR severity and mortality was noted. Indeed, the HR for mortality for TR 3 and 4 vs. no TR/TR 1 were as follows: hazard ratios (HR), 1.68; 95% confidence intervals (95% CI): 1.08–2.60, P=0.02; and HR, 2.87; 95% CI: 1.61–5.09, P<0.001, respectively. In contrast, no association between TR grade and mortality (P=0.650) was observed in patients with LVEF <50% (P-value for interaction=0.033).Conclusions:A differential prognostic effect of TR severity on 1-year mortality was observed for LVEF HF status. The association was significant only in patients with LVEF ≥50%, with increasing mortality risk as TR became more severe. (Circ J 2015; 79: 1526–1533)</description><identifier>ISSN: 1346-9843</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-15-0129</identifier><identifier>PMID: 25854896</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Acute Disease ; Acute heart failure ; Aged ; Aged, 80 and over ; Echocardiography ; Female ; Follow-Up Studies ; Heart Failure - complications ; Heart Failure - diagnostic imaging ; Heart Failure - mortality ; Heart Failure - physiopathology ; Humans ; Male ; Middle Aged ; Mortality ; Prospective Studies ; Risk Factors ; Tricuspid regurgitation ; Tricuspid Valve Insufficiency - diagnostic imaging ; Tricuspid Valve Insufficiency - etiology ; Tricuspid Valve Insufficiency - mortality ; Tricuspid Valve Insufficiency - physiopathology ; Ventricular Function, Left</subject><ispartof>Circulation Journal, 2015/06/25, Vol.79(7), pp.1526-1533</ispartof><rights>2015 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c622t-5307f37c7916432ef21f7d826f83c16bb0cc1b7e1d85255e793140b62c9842803</citedby><cites>FETCH-LOGICAL-c622t-5307f37c7916432ef21f7d826f83c16bb0cc1b7e1d85255e793140b62c9842803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1876,4009,27902,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25854896$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Santas, Enrique</creatorcontrib><creatorcontrib>Chorro, Francisco Javier</creatorcontrib><creatorcontrib>Miñana, Gema</creatorcontrib><creatorcontrib>Méndez, José</creatorcontrib><creatorcontrib>Muñoz, Jaime</creatorcontrib><creatorcontrib>Escribano, David</creatorcontrib><creatorcontrib>García-Blas, Sergio</creatorcontrib><creatorcontrib>Valero, Ernesto</creatorcontrib><creatorcontrib>Bodí, Vicent</creatorcontrib><creatorcontrib>Núñez, Eduardo</creatorcontrib><creatorcontrib>Sanchis, Juan</creatorcontrib><creatorcontrib>Núñez, Julio</creatorcontrib><title>Tricuspid Regurgitation and Mortality Risk Across Left Ventricular Systolic Function in Acute Heart Failure</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:Tricuspid regurgitation (TR) is a common echocardiographic finding that has been related to adverse outcome under various clinical scenarios. Nevertheless, evidence supporting its prognostic value in heart failure (HF) is scarce, and, in most cases, contradictory. We evaluated the association of TR grade with 1-year all-cause mortality in acute HF (AHF).Methods and Results:We included 1,842 consecutive patients admitted for AHF. Mean age was 72.8±11.3 years, 51% were female and 45.5% had LVEF <50%. The severity of TR was graded in non-TR, mild (1), moderate (2), moderate-severe (3) and severe (4). At 1-year follow-up, 370 patients (20.1%) had died. In patients with LVEF ≥50%, a significant and positive association between TR severity and mortality was noted. Indeed, the HR for mortality for TR 3 and 4 vs. no TR/TR 1 were as follows: hazard ratios (HR), 1.68; 95% confidence intervals (95% CI): 1.08–2.60, P=0.02; and HR, 2.87; 95% CI: 1.61–5.09, P<0.001, respectively. In contrast, no association between TR grade and mortality (P=0.650) was observed in patients with LVEF <50% (P-value for interaction=0.033).Conclusions:A differential prognostic effect of TR severity on 1-year mortality was observed for LVEF HF status. The association was significant only in patients with LVEF ≥50%, with increasing mortality risk as TR became more severe. (Circ J 2015; 79: 1526–1533)</description><subject>Acute Disease</subject><subject>Acute heart failure</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Tricuspid regurgitation</subject><subject>Tricuspid Valve Insufficiency - diagnostic imaging</subject><subject>Tricuspid Valve Insufficiency - etiology</subject><subject>Tricuspid Valve Insufficiency - mortality</subject><subject>Tricuspid Valve Insufficiency - physiopathology</subject><subject>Ventricular Function, Left</subject><issn>1346-9843</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkDtPwzAURi0Eorx2JuSRJcWPOI5HVFFKVYQEhdVynJvikibFdob-e9IHsNx7h_N90j0IXVMypEzwO-u8XQ5H04SKhFCmjtAZ5alM0pyR492dJSpP-QCdh7AkhCki1CkaMJGLNFfZGfqae2e7sHYlfoVF5xcumujaBpumxM-tj6Z2cYNfXfjC99a3IeAZVBF_QBO3ydp4_LYJsa2dxeOusbuwa3q4i4AnYHzEY-PqzsMlOqlMHeDqsC_Q-_hhPpoks5fHp9H9LLEZYzERnMiKSysVzVLOoGK0kmXOsirnlmZFQaylhQRa5oIJAVJxmpIiY7Z_leWEX6Dbfe_at98dhKhXLlioa9NA2wVNM8WY4pynPUr26O41D5Vee7cyfqMp0VvFeqdYj6aaCr1V3EduDu1dsYLyL_DrtAfGe2AZolnAH9CbcLaGQ6NUWm7Hf_M_8Gm8hob_APqPkfg</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>Santas, Enrique</creator><creator>Chorro, Francisco Javier</creator><creator>Miñana, Gema</creator><creator>Méndez, José</creator><creator>Muñoz, Jaime</creator><creator>Escribano, David</creator><creator>García-Blas, Sergio</creator><creator>Valero, Ernesto</creator><creator>Bodí, Vicent</creator><creator>Núñez, Eduardo</creator><creator>Sanchis, Juan</creator><creator>Núñez, Julio</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2015</creationdate><title>Tricuspid Regurgitation and Mortality Risk Across Left Ventricular Systolic Function in Acute Heart Failure</title><author>Santas, Enrique ; Chorro, Francisco Javier ; Miñana, Gema ; Méndez, José ; Muñoz, Jaime ; Escribano, David ; García-Blas, Sergio ; Valero, Ernesto ; Bodí, Vicent ; Núñez, Eduardo ; Sanchis, Juan ; Núñez, Julio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c622t-5307f37c7916432ef21f7d826f83c16bb0cc1b7e1d85255e793140b62c9842803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Disease</topic><topic>Acute heart failure</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Tricuspid regurgitation</topic><topic>Tricuspid Valve Insufficiency - diagnostic imaging</topic><topic>Tricuspid Valve Insufficiency - etiology</topic><topic>Tricuspid Valve Insufficiency - mortality</topic><topic>Tricuspid Valve Insufficiency - physiopathology</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Santas, Enrique</creatorcontrib><creatorcontrib>Chorro, Francisco Javier</creatorcontrib><creatorcontrib>Miñana, Gema</creatorcontrib><creatorcontrib>Méndez, José</creatorcontrib><creatorcontrib>Muñoz, Jaime</creatorcontrib><creatorcontrib>Escribano, David</creatorcontrib><creatorcontrib>García-Blas, Sergio</creatorcontrib><creatorcontrib>Valero, Ernesto</creatorcontrib><creatorcontrib>Bodí, Vicent</creatorcontrib><creatorcontrib>Núñez, Eduardo</creatorcontrib><creatorcontrib>Sanchis, Juan</creatorcontrib><creatorcontrib>Núñez, Julio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Santas, Enrique</au><au>Chorro, Francisco Javier</au><au>Miñana, Gema</au><au>Méndez, José</au><au>Muñoz, Jaime</au><au>Escribano, David</au><au>García-Blas, Sergio</au><au>Valero, Ernesto</au><au>Bodí, Vicent</au><au>Núñez, Eduardo</au><au>Sanchis, Juan</au><au>Núñez, Julio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tricuspid Regurgitation and Mortality Risk Across Left Ventricular Systolic Function in Acute Heart Failure</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2015</date><risdate>2015</risdate><volume>79</volume><issue>7</issue><spage>1526</spage><epage>1533</epage><pages>1526-1533</pages><issn>1346-9843</issn><eissn>1347-4820</eissn><abstract>Background:Tricuspid regurgitation (TR) is a common echocardiographic finding that has been related to adverse outcome under various clinical scenarios. Nevertheless, evidence supporting its prognostic value in heart failure (HF) is scarce, and, in most cases, contradictory. We evaluated the association of TR grade with 1-year all-cause mortality in acute HF (AHF).Methods and Results:We included 1,842 consecutive patients admitted for AHF. Mean age was 72.8±11.3 years, 51% were female and 45.5% had LVEF <50%. The severity of TR was graded in non-TR, mild (1), moderate (2), moderate-severe (3) and severe (4). At 1-year follow-up, 370 patients (20.1%) had died. In patients with LVEF ≥50%, a significant and positive association between TR severity and mortality was noted. Indeed, the HR for mortality for TR 3 and 4 vs. no TR/TR 1 were as follows: hazard ratios (HR), 1.68; 95% confidence intervals (95% CI): 1.08–2.60, P=0.02; and HR, 2.87; 95% CI: 1.61–5.09, P<0.001, respectively. In contrast, no association between TR grade and mortality (P=0.650) was observed in patients with LVEF <50% (P-value for interaction=0.033).Conclusions:A differential prognostic effect of TR severity on 1-year mortality was observed for LVEF HF status. The association was significant only in patients with LVEF ≥50%, with increasing mortality risk as TR became more severe. (Circ J 2015; 79: 1526–1533)</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>25854896</pmid><doi>10.1253/circj.CJ-15-0129</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Acute heart failure Aged Aged, 80 and over Echocardiography Female Follow-Up Studies Heart Failure - complications Heart Failure - diagnostic imaging Heart Failure - mortality Heart Failure - physiopathology Humans Male Middle Aged Mortality Prospective Studies Risk Factors Tricuspid regurgitation Tricuspid Valve Insufficiency - diagnostic imaging Tricuspid Valve Insufficiency - etiology Tricuspid Valve Insufficiency - mortality Tricuspid Valve Insufficiency - physiopathology Ventricular Function, Left |
| title | Tricuspid Regurgitation and Mortality Risk Across Left Ventricular Systolic Function in Acute Heart Failure |
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