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- W4380795140 abstract "Introduction: Tricuspid regurgitation (TR) is associated with poor outcome and high operative mortality due to late presentation; yet the optimal timing for TR intervention remains controversial, especially in asymptomatic patients. We evaluated the prognostic value of echocardiographic parameters to inform early intervention in asymptomatic TR Methods: We identified cohort of consecutive asymptomatic patients with moderate to severe (3+) or severe (4+) TR who underwent echocardiography at Cleveland Clinic during 2004-2018. Quantitative TR as well as right heart size and function parameters were determined and their prognostic utility and optimal thresholds for all-cause mortality were assessed in time-to-event analyses Results: In 325 asymptomatic TR patients (mean age 68 years; 79% female), there were 132 deaths (41%) over a median follow up of 7 years (IQR 4-11). Among the twenty echocardiographic parameters evaluated, right ventricle free wall strain (RVFWS) and tricuspid regurgitant volume (RVol) were the strongest predictors of mortality in the cohort. The optimal discriminatory thresholds for these parameters were RVFWS <-19% and RVol >45 mL ( Fig 1 ). The 5-year survival rates (95% CI) by number of risk factors (RF) were 93% (86-96%), 65% (55-74%), and 38% (26-49%) for no RF, one RF, and both RF, respectively. Compared to symptomatic TR, mortality was lower for asymptomatic TR with no RF [HR (95% CI) =0.10 (0.04-0.29)] or one RF [0.29 (0.14-0.58)], but similar for asymptomatic TR with both RF [1.11 (0.56-2.19)] ( Fig 2 ) Conclusion: RVFWS and RVol are key prognostic markers that can be serially monitored to inform optimal timing of intervention for severe asymptomatic TR" @default.
- W4380795140 created "2023-06-16" @default.
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- W4380795140 date "2022-11-08" @default.
- W4380795140 modified "2023-09-27" @default.
- W4380795140 title "Abstract 14169: Quantitative Echocardiographic Assessment and Optimal Criteria for Early Intervention in Asymptomatic Tricuspid Regurgitation" @default.
- W4380795140 doi "https://doi.org/10.1161/circ.146.suppl_1.14169" @default.
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