Right Ventricular–Pulmonary Arterial Coupling in Secondary Tricuspid Regurgitation

Chronic pressure-overload induces right ventricular (RV) adaptation to maintain RV-pulmonary arterial (PA) coupling. RV remodeling is frequently associated with secondary tricuspid regurgitation (TR) which may accelerate uncoupling. Our aim determine whether the non-invasive analysis of RV-PA coupling could improve risk stratification in patients TR. A total 1,149 (median age 72[IQR, 63 79] years, 51% men) moderate or severe TR were included. was estimated using ratio between two standard echocardiographic measurements: annular plane systolic excursion (TAPSE) and pulmonary artery pressure (PASP). The all-cause mortality across different values TAPSE/PASP analyzed a spline analysis. cut-off value identify uncoupling based on curve At time significant diagnosis median 0.35 (IQR, 0.25 0.49) mm/mm Hg. 470 (41%) demonstrated (<0.31 Hg). Patients presented more heart failure symptoms had larger left dimensions, compared those During follow-up 51 17 86) months, 586 (51%) died. cumulative 5-year survival rate lower their counterparts (37% vs 64%, p < 0.001). After correcting for potential confounders, only parameter independently (HR 1.462; 95% CI 1.192 1.793; In conclusion, poor prognosis stratification.