Prognostic impact of disproportionate secondary tricuspid regurgitation

Abstract Funding Acknowledgements Type of funding sources: None. Background Current quantitative parameters used to assess the severity secondary tricuspid regurgitation (STR) do not account for size right ventricle (RV). To address this issue, concept proportionality STR RV has been recently mutuated from mitral field improve prognostic stratification patients with STR. Purpose We sought compare value a classification based on regurgitant volume (Reg Vol) stroke guideline-recommended grading scheme severity. Methods Patients at least mild were prospectively enrolled and underwent complete 2D, Doppler 3D echocardiography measurement volumes. determine status, we evaluated difference between measured theoretical RegVol severe (the latter was defined as needed have fraction [RF] ≥ 50% according actual volume). This took into bias 8 ml in computation Reg Vol, derived Bland-Altman analysis (picture 1). Accordingly, classified non (NS_STR, RegVol< RegVol), proportionate (SP_STR, ≈ disproportionate (SD_STR, > RegVol) The incidence combined endpoint heart failure (HF) hospitalization death any cause primary endpoint. Results 333 consecutive (mean age 71±14 years, 53.3 % women). After median follow up 20 months (10–32), 134 (40.2%) reached end point. SD_STR showed significantly higher events (67.9%) comparison SP_STR (40.6%, p = 0.005 difference) NS_STR (31.3%, p<0.001 2). At Cox multivariate analysis, (adjusted age, atrial fibrillation, volume, free-wall longitudinal strain, ejection fraction) independently correlated hazard ratio: 1.785; 95% confidence interval [CI]: 1.249–2.550; 0.002). When tested same variables, conventional grade lost its independent correlation point (p 0.258). Conclusions Disproportionate is associated all-cause mortality or hospitalization, it improves risk compared