Author + information
- Erin Fender,
- Sorin Pislaru,
- Vuyisile Nkomo,
- David Hodge and
- Rick Nishimura
Background: There is a large population of patients with isolated functional tricuspid regurgitation (ITR) in whom no predisposing left heart disease (LHD) or pulmonary hypertension (PH) is identified. Understanding the natural history of ITR is critical to determining the role for invasive therapies, particularly as TV surgery is associated with high mortality and new low risk percutaneous therapies are in active development.
Methods: We identified local residents with ≥ moderate-severe ITR between 2005-2016. Patients with ≥ moderate-severe aortic or mitral disease, congenital disease, ejection fraction (EF) <25%, or pulmonary systolic pressure >50 mmHg were excluded. Observed survival was compared to expected using an age and sex matched population.
Results: In 755 ITR patients, the mean age was 79 years, 31% were male, 12% had previous left valve surgery, the mean EF was 54%, 73% had atrial fibrillation, 25% had a pacemaker/defibrillator, and 6.8% had ≥moderate-severe right ventricular dysfunction. Over 5 years 63% were hospitalized for heart failure (HF) and these patients experienced a mean of 1.8 HF admissions per year. TR surgery was performed in only 2.3%. Observed survival was lower than expected (41% vs 69%, p<0.001, Figure 1).
Conclusions: Despite the absence of LHD and PH, patients with ≥moderate-severe ITR experience increased mortality compared to a matched population. This suggests earlier interventions, including percutaneous interventions, may be appropriate in some circumstances.
Moderated Poster Contributions
Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-9:55 a.m.
Session Title: Tricuspid Regurgitation: Signals in Plain Sight
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1303M-03
- 2017 American College of Cardiology Foundation