Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease

Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease

Background: Left-sided heart disease is the leading etiology of tricuspid regurgitation (TR) in heart failure (HF); however, the association between different HF phenotypes and the adverse effects of TR remains unclear. Objectives: The authors aimed to elucidate the association between TR and outcom...

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Main Authors: Mitsunobu Kitamura, MD, Kazuaki Amami, MD, Tomoyuki Yaguchi, MD, Kouya Okabe, MD, Yasuyuki Shiraishi, MD, Ryo Nakamaru, MD, Yuji Nagatomo, MD, Ayumi Goda, MD, Michiru Nomoto, MD, Atsushi Mizuno, MD, Munehisa Sakamoto, MD, Yumiko K. Ichihara, MD, Takashi Kohno, MD, Shun Kohsaka, MD, Tsutomu Yoshikawa, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JACC: Advances
Subjects:
cohort study
heart failure
left ventricular dysfunction
tricuspid regurgitation
valvular heart disease
Online Access:http://www.sciencedirect.com/science/article/pii/S2772963X25002510
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Summary:Background: Left-sided heart disease is the leading etiology of tricuspid regurgitation (TR) in heart failure (HF); however, the association between different HF phenotypes and the adverse effects of TR remains unclear. Objectives: The authors aimed to elucidate the association between TR and outcomes across the subtypes of left-sided heart disease in patients hospitalized for HF. Methods: We analyzed data from the multicenter West Tokyo Heart Failure registry between January 2006 and December 2021. Moderate or severe mitral or aortic valve disease was defined as left-sided valve dysfunction (LVD). Patients with congenital heart disease, secondary cardiomyopathy, systemic conditions related to HF, or those with incomplete datasets were excluded. Using a multivariable Cox hazard model, the survival effect of TR on mortality in patients with LVD was examined. Results: Overall, 3,040 presented with LVD (median age, 80 years; 45.9% female), and 2,438 had no LVD (median age, 74 years; 27.8% female). The prevalence of moderate and severe TR was 27.6% and 6.5% in patients with LVD and 9.2% and 1.5% in those without LVD, respectively. The adjusted HRs of moderate and severe TR for mortality were 1.25 (95% CI: 1.03-1.52) and 1.72 (95% CI: 1.30-2.29) in those with LVD, respectively, and 2.15 (95% CI: 1.62-2.84) and 3.09 (95% CI: 1.87-5.09) in those without LVD, respectively. Significant interactions between the subtypes were observed (P = 0.005). Conclusions: TR severity stratified mortality after acute decompensated HF better in patients without LVD than in those with LVD.
ISSN:2772-963X

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