Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation

Tricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. We utilized our large institutional echocardiographic registry, integrated with the electronic medical record-based health system registry to identify patients with varying degr...

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Main Authors: Yasser M. Sammour, Budhaditya Bose, Chloe Kharsa, Sherif F. Nagueh, Neal S. Kleiman, Waqas Qureshi, Nadeen Faza, Joe Aoun, Sadeer Al-kindi, William A. Zoghbi, Sachin S. Goel, Khurram Nasir, Stephen H. Little
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:American Heart Journal Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666602225000680
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author Yasser M. Sammour
Budhaditya Bose
Chloe Kharsa
Sherif F. Nagueh
Neal S. Kleiman
Waqas Qureshi
Nadeen Faza
Joe Aoun
Sadeer Al-kindi
William A. Zoghbi
Sachin S. Goel
Khurram Nasir
Stephen H. Little
author_facet Yasser M. Sammour
Budhaditya Bose
Chloe Kharsa
Sherif F. Nagueh
Neal S. Kleiman
Waqas Qureshi
Nadeen Faza
Joe Aoun
Sadeer Al-kindi
William A. Zoghbi
Sachin S. Goel
Khurram Nasir
Stephen H. Little
author_sort Yasser M. Sammour
collection DOAJ
description Tricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. We utilized our large institutional echocardiographic registry, integrated with the electronic medical record-based health system registry to identify patients with varying degrees of TR, and to assess its association with long-term outcomes. Patients were categorized by TR severity as none, mild, moderate, or severe. A total of 88,511 unique individuals were included (44.7 % no reported TR, 49.0 % mild, 4.8 % moderate, and 1.5 % severe). Greater TR severity was associated with advanced age, female sex, and Black race, alongside higher prevalence of baseline comorbidities. Patients with moderate or severe TR exhibited worse congestion biomarkers, creatinine, liver enzymes, and reduced platelet counts. Echocardiographically, moderate or severe TR correlated with lower tricuspid annular plane systolic excursion, left ventricular ejection fraction, as well as larger biatrial and left ventricular volumes. There was a significant association between increasing TR severity and all-cause mortality at 3 years from the index echocardiogram compared with no TR (Moderate TR: AdjHR 1.76; 95 % CI 1.63–1.89; Severe TR: AdjHR 2.40; 95 % CI 2.16–2.66), and similarly for hospitalization (Moderate TR: AdjHR 1.14; 95 % CI 1.08–1.20; Severe TR: AdjHR 1.25; 95 % CI 1.15–1.36). In this large cross-sectional analysis, we highlight how institutional echocardiographic registries can be leveraged to identify the burden of TR, including its significant association with higher mortality and healthcare utilization. These findings emphasize the need for heightened clinical attention and potential intervention in patients with significant TR as tricuspid valve therapies evolve.
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spelling doaj-art-6d0b89964db24cedbcd62635bbbc1fa42025-08-20T03:27:51ZengElsevierAmerican Heart Journal Plus2666-60222025-08-015610056510.1016/j.ahjo.2025.100565Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitationYasser M. Sammour0Budhaditya Bose1Chloe Kharsa2Sherif F. Nagueh3Neal S. Kleiman4Waqas Qureshi5Nadeen Faza6Joe Aoun7Sadeer Al-kindi8William A. Zoghbi9Sachin S. Goel10Khurram Nasir11Stephen H. Little12Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaHouston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaCorresponding author at: John S. Dunn Chair in Clinical Cardiovascular Research and Education, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin, Suite SM677, Houston, TX 77030, United States of America.; Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States of AmericaTricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. We utilized our large institutional echocardiographic registry, integrated with the electronic medical record-based health system registry to identify patients with varying degrees of TR, and to assess its association with long-term outcomes. Patients were categorized by TR severity as none, mild, moderate, or severe. A total of 88,511 unique individuals were included (44.7 % no reported TR, 49.0 % mild, 4.8 % moderate, and 1.5 % severe). Greater TR severity was associated with advanced age, female sex, and Black race, alongside higher prevalence of baseline comorbidities. Patients with moderate or severe TR exhibited worse congestion biomarkers, creatinine, liver enzymes, and reduced platelet counts. Echocardiographically, moderate or severe TR correlated with lower tricuspid annular plane systolic excursion, left ventricular ejection fraction, as well as larger biatrial and left ventricular volumes. There was a significant association between increasing TR severity and all-cause mortality at 3 years from the index echocardiogram compared with no TR (Moderate TR: AdjHR 1.76; 95 % CI 1.63–1.89; Severe TR: AdjHR 2.40; 95 % CI 2.16–2.66), and similarly for hospitalization (Moderate TR: AdjHR 1.14; 95 % CI 1.08–1.20; Severe TR: AdjHR 1.25; 95 % CI 1.15–1.36). In this large cross-sectional analysis, we highlight how institutional echocardiographic registries can be leveraged to identify the burden of TR, including its significant association with higher mortality and healthcare utilization. These findings emphasize the need for heightened clinical attention and potential intervention in patients with significant TR as tricuspid valve therapies evolve.http://www.sciencedirect.com/science/article/pii/S2666602225000680TRValvular heart diseaseEchocardiographyRegistryBig data
spellingShingle Yasser M. Sammour
Budhaditya Bose
Chloe Kharsa
Sherif F. Nagueh
Neal S. Kleiman
Waqas Qureshi
Nadeen Faza
Joe Aoun
Sadeer Al-kindi
William A. Zoghbi
Sachin S. Goel
Khurram Nasir
Stephen H. Little
Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation
American Heart Journal Plus
TR
Valvular heart disease
Echocardiography
Registry
Big data
title Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation
title_full Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation
title_fullStr Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation
title_full_unstemmed Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation
title_short Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation
title_sort leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation
topic TR
Valvular heart disease
Echocardiography
Registry
Big data
url http://www.sciencedirect.com/science/article/pii/S2666602225000680
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