Abstract
Introduction
Isolated tricuspid regurgitation (TR) prevalence is increasing in the last decades. Its presence is associated with a worse prognosis when EROA is >40 mm2. Because of high surgery risk and increasing incidence, isolated TR is a challenge in modern cardiology.
Purpose
To evaluate the prevalence and characteristics of isolated TR compared to other TR aetiologies in a large cohort of patients.
Methods
Prospective study where consecutive patients undergoing an echocardiographic study within a three-month period were included. All studies with at least moderate TR were selected. Isolated TR was defined as TR with no likely pulmonary hypertension (>50 mmHg), no overt TR cause (no intrinsic tricuspid disease, LVEF ≥50%, no pacemaker/defibrillator wire across the tricuspid, no other significant valve disease, no disease that may cause TR, no congenital or pericardial heart disease); and no previous valve surgery. Patients with isolated TR and other aetiologies were compared.
Results
2121 patients with at least moderate TR were included. Isolated TR was found in 398 patients (18.8%). Basal characteristics are shown in table 1. Patients with isolated TR did not have a higher prevalence of AF (47.5% vs. 48.6% p=0.362). Isolated TR was less severe (20.5% vs. 32.1% of patients with severe TR; p<0.001) and less symptomatic (NYHA ≥ II in 27.8% of patients vs. 69.3%; p<0.001).
After selecting patients with at least severe TR, patients with isolated TR were also less symptomatic (NYHA≥II in 47.8% of patients vs. 70.7%; p<0.001) and they had better RV function (TAPSE <17 mm in 13.4% vs. 35.6%; p=0.001).
We found that patients with isolated severe TR had a larger tricuspid annulus diameter (25.4±0.8 mm/m2 vs. 24.0±0.3 mm/m2; p=0.047).
Conclusions
In this large prospective study, isolated TR is present in 18.8% of significant TR. Isolated TR was less severe, was associated with less RV dilatation (but with larger tricuspid annulus diameter) and patients had a better functional class compared to other TR aetiologies.
Differeces in NYHA and RV function
Funding Acknowledgement
Type of funding source: None
Three-Dimensional Geometry of the Tricuspid Annulus in Healthy Subjects and in Patients With Functional Tricuspid Regurgitation: A Real-Time, 3-Dimensional Echocardiographic Study