Prognostic Implications of Significant Isolated Tricuspid Regurgitation in Patients With Atrial Fibrillation Without Left-Sided Heart Disease or Pulmonary Hypertension
The prognostic impact of isolated tricuspid regurgitation (TR) in patients with atrial fibrillation (AF) has not been investigated. The purpose of this study was to investigate the prognostic implications of significant isolated TR in AF patients without left-sided heart disease, pulmonary hypertens...
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| Veröffentlicht in: | The American journal of cardiology 2020-11, Vol.135, p.84-90 |
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| container_title | The American journal of cardiology |
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| creator | Dietz, Marlieke F Goedemans, Laurien Vo, N Mai Prihadi, Edgard A van der Bijl, Pieter Gersh, Bernard J Ajmone Marsan, Nina Delgado, Victoria Bax, Jeroen J |
| description | The prognostic impact of isolated tricuspid regurgitation (TR) in patients with atrial fibrillation (AF) has not been investigated. The purpose of this study was to investigate the prognostic implications of significant isolated TR in AF patients without left-sided heart disease, pulmonary hypertension, or primary structural abnormalities of the tricuspid valve.
A total of 63 AF patients with moderate and severe TR were matched for age and gender to 116 AF patients without significant TR. Patients were followed for the occurrence of all-cause mortality, hospitalization for heart failure and stroke. Patients with significant isolated TR (mean age 71 ± 8 years, 57% men) more often had paroxysmal AF as compared with patients without TR (mean age 71 ± 7 years, 60% men) (60% vs 43%, p = 0.028). In addition, right atrial size and tricuspid annular diameter were significantly larger in patients with significant isolated TR compared with their counterparts. During follow-up (median 62 [34 to 95] months), 53 events for the combined endpoint occurred. One- and 5-year event-free survival rates for patients with significant isolated TR were 76% and 56%, compared with 92% and 85% for patients without significant TR, respectively (Log rank Chi-Square p |
| doi_str_mv | 10.1016/j.amjcard.2020.08.034 |
| format | Article |
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A total of 63 AF patients with moderate and severe TR were matched for age and gender to 116 AF patients without significant TR. Patients were followed for the occurrence of all-cause mortality, hospitalization for heart failure and stroke. Patients with significant isolated TR (mean age 71 ± 8 years, 57% men) more often had paroxysmal AF as compared with patients without TR (mean age 71 ± 7 years, 60% men) (60% vs 43%, p = 0.028). In addition, right atrial size and tricuspid annular diameter were significantly larger in patients with significant isolated TR compared with their counterparts. During follow-up (median 62 [34 to 95] months), 53 events for the combined endpoint occurred. One- and 5-year event-free survival rates for patients with significant isolated TR were 76% and 56%, compared with 92% and 85% for patients without significant TR, respectively (Log rank Chi-Square p <0.001). The presence of significant isolated TR was independently associated with the combined endpoint (hazard ratio, 2.853; 95% confidence interval, 1.458 to 5.584; p = 0.002). In conclusion, in the absence of left-sided heart disease and pulmonary hypertension, significant isolated TR is independently associated with worse event-free survival in patients with AF.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2020.08.034</identifier><identifier>PMID: 32866441</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Ablation ; Abnormalities ; Age ; Aged ; Atrial Fibrillation - complications ; Atrial Fibrillation - mortality ; Cardiac arrhythmia ; Cardiology ; Cardiovascular disease ; Cardiovascular diseases ; Catheters ; Cohort Studies ; Confidence intervals ; Congestive heart failure ; Coronary artery disease ; Coronary vessels ; Ejection fraction ; Female ; Fibrillation ; Gender ; Heart Diseases ; Heart failure ; Humans ; Hypertension ; Hypertension, Pulmonary ; Information systems ; Lung diseases ; Male ; Medical prognosis ; Middle Aged ; Mortality ; Population ; Prognosis ; Pulmonary arteries ; Pulmonary hypertension ; Regression analysis ; Regurgitation ; Retrospective Studies ; Rheumatic heart disease ; Stroke ; Survival ; Tricuspid valve ; Tricuspid Valve Insufficiency - complications ; Tricuspid Valve Insufficiency - mortality</subject><ispartof>The American journal of cardiology, 2020-11, Vol.135, p.84-90</ispartof><rights>2020 The Author(s)</rights><rights>Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><rights>2020. The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-647dee116db0ec2e0e933c1356a85a83110499e0f637843dbc50b7c4a126eb5c3</citedby><cites>FETCH-LOGICAL-c440t-647dee116db0ec2e0e933c1356a85a83110499e0f637843dbc50b7c4a126eb5c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914920308912$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32866441$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dietz, Marlieke F</creatorcontrib><creatorcontrib>Goedemans, Laurien</creatorcontrib><creatorcontrib>Vo, N Mai</creatorcontrib><creatorcontrib>Prihadi, Edgard A</creatorcontrib><creatorcontrib>van der Bijl, Pieter</creatorcontrib><creatorcontrib>Gersh, Bernard J</creatorcontrib><creatorcontrib>Ajmone Marsan, Nina</creatorcontrib><creatorcontrib>Delgado, Victoria</creatorcontrib><creatorcontrib>Bax, Jeroen J</creatorcontrib><title>Prognostic Implications of Significant Isolated Tricuspid Regurgitation in Patients With Atrial Fibrillation Without Left-Sided Heart Disease or Pulmonary Hypertension</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The prognostic impact of isolated tricuspid regurgitation (TR) in patients with atrial fibrillation (AF) has not been investigated. The purpose of this study was to investigate the prognostic implications of significant isolated TR in AF patients without left-sided heart disease, pulmonary hypertension, or primary structural abnormalities of the tricuspid valve.
A total of 63 AF patients with moderate and severe TR were matched for age and gender to 116 AF patients without significant TR. Patients were followed for the occurrence of all-cause mortality, hospitalization for heart failure and stroke. Patients with significant isolated TR (mean age 71 ± 8 years, 57% men) more often had paroxysmal AF as compared with patients without TR (mean age 71 ± 7 years, 60% men) (60% vs 43%, p = 0.028). In addition, right atrial size and tricuspid annular diameter were significantly larger in patients with significant isolated TR compared with their counterparts. During follow-up (median 62 [34 to 95] months), 53 events for the combined endpoint occurred. One- and 5-year event-free survival rates for patients with significant isolated TR were 76% and 56%, compared with 92% and 85% for patients without significant TR, respectively (Log rank Chi-Square p <0.001). The presence of significant isolated TR was independently associated with the combined endpoint (hazard ratio, 2.853; 95% confidence interval, 1.458 to 5.584; p = 0.002). In conclusion, in the absence of left-sided heart disease and pulmonary hypertension, significant isolated TR is independently associated with worse event-free survival in patients with AF.</description><subject>Ablation</subject><subject>Abnormalities</subject><subject>Age</subject><subject>Aged</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - mortality</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Catheters</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Congestive heart failure</subject><subject>Coronary artery disease</subject><subject>Coronary vessels</subject><subject>Ejection fraction</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Gender</subject><subject>Heart Diseases</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary</subject><subject>Information systems</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Population</subject><subject>Prognosis</subject><subject>Pulmonary arteries</subject><subject>Pulmonary hypertension</subject><subject>Regression analysis</subject><subject>Regurgitation</subject><subject>Retrospective Studies</subject><subject>Rheumatic heart disease</subject><subject>Stroke</subject><subject>Survival</subject><subject>Tricuspid valve</subject><subject>Tricuspid Valve Insufficiency - complications</subject><subject>Tricuspid Valve Insufficiency - mortality</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc1u1DAUhS0EokPhEUCW2LBJsGPHSVaoKpQZaSRGtIil5dg3g0eJHWwHqU_U16yHGViwYeW_75zrew9CrykpKaHi_aFU00GrYMqKVKQkbUkYf4JWtG26gnaUPUUrQkhVdJR3F-hFjId8pLQWz9EFq1ohOKcr9LALfu98TFbjzTSPVqtkvYvYD_jW7p0d8o1LeBP9qBIYfBesXuJsDf4K-yXsbfotwNbhXd6BSxF_t-kHvkrBqhHf2D7YcTxBxwe_JLyFIRW31mS_NaiQ8EcbQUXAPuDdMk7eqXCP1_czhAQuZulL9GxQY4RX5_USfbv5dHe9LrZfPm-ur7aF5pykQvDGAFAqTE9AV0CgY0xTVgvV1qpllBLedUAGwZqWM9PrmvSN5opWAvpas0v07uQ7B_9zgZjkZKOG3IADv0RZcdaJigraZvTtP-jBL8Hl32WqztMVpDlS9YnSwccYYJBzsFNuT1Iij0nKgzwnKY9JStLKnGTWvTm7L_0E5q_qT3QZ-HACII_jl4Ugo87j12BsAJ2k8fY_JR4BJtK0xw</recordid><startdate>20201115</startdate><enddate>20201115</enddate><creator>Dietz, Marlieke F</creator><creator>Goedemans, Laurien</creator><creator>Vo, N Mai</creator><creator>Prihadi, Edgard A</creator><creator>van der Bijl, Pieter</creator><creator>Gersh, Bernard J</creator><creator>Ajmone Marsan, Nina</creator><creator>Delgado, Victoria</creator><creator>Bax, Jeroen J</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><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>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20201115</creationdate><title>Prognostic Implications of Significant Isolated Tricuspid Regurgitation in Patients With Atrial Fibrillation Without Left-Sided Heart Disease or Pulmonary Hypertension</title><author>Dietz, Marlieke F ; Goedemans, Laurien ; Vo, N Mai ; Prihadi, Edgard A ; van der Bijl, Pieter ; Gersh, Bernard J ; Ajmone Marsan, Nina ; Delgado, Victoria ; Bax, Jeroen J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-647dee116db0ec2e0e933c1356a85a83110499e0f637843dbc50b7c4a126eb5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ablation</topic><topic>Abnormalities</topic><topic>Age</topic><topic>Aged</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - mortality</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Catheters</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Congestive heart failure</topic><topic>Coronary artery disease</topic><topic>Coronary vessels</topic><topic>Ejection fraction</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Gender</topic><topic>Heart Diseases</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Pulmonary</topic><topic>Information systems</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Population</topic><topic>Prognosis</topic><topic>Pulmonary arteries</topic><topic>Pulmonary hypertension</topic><topic>Regression analysis</topic><topic>Regurgitation</topic><topic>Retrospective Studies</topic><topic>Rheumatic heart disease</topic><topic>Stroke</topic><topic>Survival</topic><topic>Tricuspid valve</topic><topic>Tricuspid Valve Insufficiency - complications</topic><topic>Tricuspid Valve Insufficiency - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dietz, Marlieke F</creatorcontrib><creatorcontrib>Goedemans, Laurien</creatorcontrib><creatorcontrib>Vo, N Mai</creatorcontrib><creatorcontrib>Prihadi, Edgard A</creatorcontrib><creatorcontrib>van der Bijl, Pieter</creatorcontrib><creatorcontrib>Gersh, Bernard J</creatorcontrib><creatorcontrib>Ajmone Marsan, Nina</creatorcontrib><creatorcontrib>Delgado, Victoria</creatorcontrib><creatorcontrib>Bax, Jeroen J</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dietz, Marlieke F</au><au>Goedemans, Laurien</au><au>Vo, N Mai</au><au>Prihadi, Edgard A</au><au>van der Bijl, Pieter</au><au>Gersh, Bernard J</au><au>Ajmone Marsan, Nina</au><au>Delgado, Victoria</au><au>Bax, Jeroen J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Implications of Significant Isolated Tricuspid Regurgitation in Patients With Atrial Fibrillation Without Left-Sided Heart Disease or Pulmonary Hypertension</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2020-11-15</date><risdate>2020</risdate><volume>135</volume><spage>84</spage><epage>90</epage><pages>84-90</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>The prognostic impact of isolated tricuspid regurgitation (TR) in patients with atrial fibrillation (AF) has not been investigated. The purpose of this study was to investigate the prognostic implications of significant isolated TR in AF patients without left-sided heart disease, pulmonary hypertension, or primary structural abnormalities of the tricuspid valve.
A total of 63 AF patients with moderate and severe TR were matched for age and gender to 116 AF patients without significant TR. Patients were followed for the occurrence of all-cause mortality, hospitalization for heart failure and stroke. Patients with significant isolated TR (mean age 71 ± 8 years, 57% men) more often had paroxysmal AF as compared with patients without TR (mean age 71 ± 7 years, 60% men) (60% vs 43%, p = 0.028). In addition, right atrial size and tricuspid annular diameter were significantly larger in patients with significant isolated TR compared with their counterparts. During follow-up (median 62 [34 to 95] months), 53 events for the combined endpoint occurred. One- and 5-year event-free survival rates for patients with significant isolated TR were 76% and 56%, compared with 92% and 85% for patients without significant TR, respectively (Log rank Chi-Square p <0.001). The presence of significant isolated TR was independently associated with the combined endpoint (hazard ratio, 2.853; 95% confidence interval, 1.458 to 5.584; p = 0.002). In conclusion, in the absence of left-sided heart disease and pulmonary hypertension, significant isolated TR is independently associated with worse event-free survival in patients with AF.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32866441</pmid><doi>10.1016/j.amjcard.2020.08.034</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Ablation Abnormalities Age Aged Atrial Fibrillation - complications Atrial Fibrillation - mortality Cardiac arrhythmia Cardiology Cardiovascular disease Cardiovascular diseases Catheters Cohort Studies Confidence intervals Congestive heart failure Coronary artery disease Coronary vessels Ejection fraction Female Fibrillation Gender Heart Diseases Heart failure Humans Hypertension Hypertension, Pulmonary Information systems Lung diseases Male Medical prognosis Middle Aged Mortality Population Prognosis Pulmonary arteries Pulmonary hypertension Regression analysis Regurgitation Retrospective Studies Rheumatic heart disease Stroke Survival Tricuspid valve Tricuspid Valve Insufficiency - complications Tricuspid Valve Insufficiency - mortality |
| title | Prognostic Implications of Significant Isolated Tricuspid Regurgitation in Patients With Atrial Fibrillation Without Left-Sided Heart Disease or Pulmonary Hypertension |
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