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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Elsevier
2025-06-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X25002510 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Mitsunobu Kitamura, MD |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-fed92d9cc1e1457681da4eb36434c552 |
| institution | OA Journals |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-fed92d9cc1e1457681da4eb36434c5522025-08-20T02:30:03ZengElsevierJACC: Advances2772-963X2025-06-014610183210.1016/j.jacadv.2025.101832Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart DiseaseMitsunobu Kitamura, MD0Kazuaki Amami, MD1Tomoyuki Yaguchi, MD2Kouya Okabe, MD3Yasuyuki Shiraishi, MD4Ryo Nakamaru, MD5Yuji Nagatomo, MD6Ayumi Goda, MD7Michiru Nomoto, MD8Atsushi Mizuno, MD9Munehisa Sakamoto, MD10Yumiko K. Ichihara, MD11Takashi Kohno, MD12Shun Kohsaka, MD13Tsutomu Yoshikawa, MD14Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan; Address for correspondence: Dr Mitsunobu Kitamura, Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan.Department of Cardiology, Sakakibara Heart Institute, Tokyo, JapanDepartment of Cardiology, Sakakibara Heart Institute, Tokyo, JapanDepartment of Cardiology, Sakakibara Heart Institute, Tokyo, JapanDepartment of Cardiology, Keio University School of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, JapanDepartment of Cardiology, National Defense Medical College, Saitama, JapanDepartment of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, JapanDepartment of Cardiology, Saitama University International Medical Hospital, Saitama, JapanDepartment of Cardiology St Luke's International Hospital, Tokyo, JapanDepartment of Cardiology, National Hospital Organization Tokyo Medical Center, Tokyo, JapanDepartment of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, JapanDepartment of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, JapanDepartment of Cardiology, Keio University School of Medicine, Tokyo, JapanDepartment of Cardiology, Sakakibara Heart Institute, Tokyo, JapanBackground: 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.http://www.sciencedirect.com/science/article/pii/S2772963X25002510cohort studyheart failureleft ventricular dysfunctiontricuspid regurgitationvalvular heart disease |
| spellingShingle | 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 Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease JACC: Advances cohort study heart failure left ventricular dysfunction tricuspid regurgitation valvular heart disease |
| title | Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease |
| title_full | Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease |
| title_fullStr | Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease |
| title_full_unstemmed | Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease |
| title_short | Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease |
| title_sort | association of tricuspid regurgitation with mortality in heart failure with left sided heart disease |
| topic | cohort study heart failure left ventricular dysfunction tricuspid regurgitation valvular heart disease |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X25002510 |
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