Impact of tricuspid regurgitation severity on mortality in pulmonary hypertension patients: A comprehensive analysis

Curr Probl Cardiol. 2024 Apr;49(4):102405. doi: 10.1016/j.cpcardiol.2024.102405. Epub 2024 Jan 21.

Abstract

Background: Pulmonary hypertension (PH) presents as a complex cardiovascular condition with a highly variable prognosis. Secondary tricuspid regurgitation (TR), a frequent comorbidity in PH, has an uncertain impact on patient outcomes. This study investigates the relationship between the severity of TR and mortality in patients with PH.

Methods: A retrospective analysis of 110 PH patients who underwent right-heart catheterization was conducted. TR severity was categorized echocardiographically as mild, moderate, or severe. Both univariate and multivariate Cox regression analyses were used to assess predictors of mortality.

Results: The median age of the cohort was 60 years, predominantly female (65 %). Severe TR was present in 36 % of patients. Over a 20-month median follow-up, mortality was notably higher in patients with severe TR (30 %) compared to those with milder forms (15 %, p = 0.04). Multivariate analysis confirmed severe TR, WHO functional class III/IV, and right ventricular stroke work index as independent predictors of mortality.

Conclusion: Severe TR significantly predicts increased mortality in PH patients, underscoring its importance in patient management. These findings advocate for early detection and comprehensive management of TR, integrating its assessment into routine PH care to potentially enhance patient outcomes.

Keywords: Echocardiogram; Hemodynamics; Mortality; Pulmonary hypertension; Tricuspid regurgitation.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization
  • Female
  • Humans
  • Hypertension, Pulmonary* / diagnosis
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Tricuspid Valve Insufficiency* / complications
  • Tricuspid Valve Insufficiency* / diagnosis