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- Title
Clinical utility and prognostic value of right atrial function in severe tricuspid regurgitation: one more piece of the puzzle.
- Authors
Hinojar, Rocio; Fernández-Golfín, Covadonga; Gómez, Ariana González; García-Martin, Ana; Monteagudo, Juan Manuel; Lunar, Inés García; Sebastian, Cristina García; Rivas, Sonia; Recalde, Angel Sanchez; Zamorano, Jose Luis
- Abstract
Aims The optimal management of severe tricuspid regurgitation (TR) remains controversial. While right ventricular systolic function is an established prognostic marker of outcomes, the potential role of right atrial (RA) function is unknown. This study aimed to describe RA function by 2D speckle-tracking echocardiography (STE) in at least severe TR and to evaluate its potential association with cardiovascular outcomes. Methods and results Consecutive patients with at least (≥) severe TR (severe, massive, or torrential TR) evaluated in the Heart Valve Clinic following a comprehensive clinical protocol were included. Consecutive control subjects and patients with permanent isolated atrial fibrillation (AF) were included for comparison (control and AF group, respectively). RA function was measured with 2D-STE and two components of RA function were calculated: reservoir (RASr) and contractile (RASct) strain (AutoStrain, Philips Medical Systems the EPIQ system). A combined endpoint of hospital admission due to heart failure (HF) or all-cause mortality was defined. Patients with ≥ severe TR (n = 140) showed lower RASr compared with controls (n = 20) and with the AF group (n = 20) (P < 0.001). Atrial TR showed lower RASr compared with other aetiologies of TR (P < 0.001). After a median follow-up of 2.2 years (IQR: 12–41 months), RASr remained an independent predictor of mortality and HF. A cut-off value of RASr of <9.4% held the best accuracy to predict outcomes. Conclusion RA function by 2D-STE independently predicts mortality and HF hospitalizations in patients with ≥ severe TR.
- Subjects
HEART valve diseases; ECHOCARDIOGRAPHY; CARDIOVASCULAR system physiology; MORTALITY; TRICUSPID valve; SEVERITY of illness index; RESEARCH funding; HOSPITAL care; DESCRIPTIVE statistics; RIGHT heart atrium; HEART failure
- Publication
European Heart Journal - Cardiovascular Imaging, 2023, Vol 24, Issue 8, p1092
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jead052