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Associations between functional tricuspid regurgitation and long-term outcomes for patients with pulmonary hypertension

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ARTICLE DOWNLOAD

Associations between functional tricuspid regurgitation and long-term outcomes for patients with pulmonary hypertension

10$

Jun Mukai, Hidekazu Tanaka, Hiroyuki Sano, Shun Yokota, Makiko Suto, Hiroki Takada, Fumitaka Soga, Yutaka Hatani, Hiroki Matsuzoe, Keiko Hatazawa, Kensuke Matsumoto, Kazuhiko Nakayama, Noriaki Emoto & Ken-ichi Hirata 

Abstract

Functional tricuspid regurgitation (FTR) is associated with prognosis for various heart diseases, but its association with pulmonary hypertension (PH) remains unclear. We studied 111 PH patients. Mid-term follow-up echocardiography was performed 7.1 ± 4.1 months after PH-specific therapy. The severity of FTR was graded as none or trace, mild, moderate, or severe, while more than moderate TR was defined as significant. Moreover, mid-term improvement in FTR after therapy was defined as an improvement in severity of FTR by a grade of 1 or more. Long-term follow-up to determine the primary endpoint of death or hospitalization for heart failure lasted 39 ± 14 months. Mid-term improvement in FTR after PH-specific treatment was observed in 25 patients (23%), and the primary end points occurred in 27 patients (24%) during the long-term follow-up. The Kaplan–Meier curve indicated that the non-FTR group showed more favorable long-term outcomes than the FTR group (log-rank P = 0.008). It further indicated that patients with mid-term improvement in FTR also had more favorable long-term outcomes than those without such improvement (log-rank P = 0.03). When divided into four sub-groups based on combined assessment of baseline FTR and mid-term improvement in FTR, long-term outcomes for patients without mid-term improvement in their baseline FTR were worse than for the other sub-groups (log-rank P = 0.02). Multiple regression analysis showed that a relative change in tricuspid annular diameter at the mid-term follow-up after PH-specific therapy was the only independent determinant parameters for mid-term improvement in FTR. FTR appears to be a valuable factor for predicting long-term outcomes for PH patients, and combined assessment of baseline FTR and mid-term improvement in FTR after PH-specific therapy may have clinical implications for better management of such patients.

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Year 2020
Language English
Format PDF
DOI 10.1007/s10554-020-01824-6