Clinical and echocardiographic characterization of patients hospitalized for severe tricuspid valve regurgitation: a single tertiary -care center experience with 2-year follow -up

INTRODUCTION Tricuspid regurgitation (TR) is a common acquired valvular heart disease. Recently, transcatheter treatment options for severe TR have emerged that could change management of condition, which warrants better characterization of this specific patient group. OBJECTIVES The aim of the study was to describe the clinical and echocardiographic characteristics of patients with severe TR and to evaluate their short- and mid-term prognosis. PATIENTS AND METHODS This retrospective, observational, single-center study enrolled consecutive patients with severe TR hospitalized between January 2016 and September 2021 in the Department of Cardiology, Medical University of Warsaw, Poland. The severity of heart failure (HF) was evaluated using the New York Heart Association classification. Echocardiographic assessment was performed an experienced sonographer. EuroSCORE II and TRI-SCORE models were computed for each patient, 12- and 24-month clinical outcomes were reported. RESULTS The study comprised 172 patients (93 women [54.1%]) at a mean (SD) age of 76.4 (10.5) years. The most common comorbidities included: atrial fibrillation (84.9%), hypertension (68%), chronic kidney disease (54.1%), coronary artery disease (45.3%), and diabetes mellitus (30.9%). The median (interquartile range) EuroSCORE II and TRI-SCORE values were 4.68% (2.88%-8.05%) and 14% (5%-34%), respectively. The median follow-up was 24 (8.5-41) months. The overall mortality was 29.7% at 1 year and 47.3% at 2 years. TR grade, tricuspid annular plane systolic excursion (TAPSE) above 17 mm, TAPSE to systolic pulmonary artery pressure ratio below 0.26, and increased right atrial area were significant factors associated with mortality. CONCLUSIONS Patients presenting with severe TR are characterized by a large comorbidity burden poor prognosis, despite intensive HF management.