Abstract 17332: Prognostic Impact of Right Ventricular Function and Tricuspid Regurgitation in Functional Mitral Regurgitation: A Meta-Analysis

Abstract

Introduction: Right ventricular dysfunction and tricuspid regurgitation grade are associated with cardiovascular mortality in the general population, primary MR, and other cardiovascular diseases. Hypothesis: The objective of this study was to investigate the prognostic importance of RVD, and TR in patients with functional mitral regurgitation (FMR) Methods: A systemic review and meta-analysis were performed using MEDLINE, Scopus, and Embase to assess the prognostic value of RVD and TR grade for mortality. RVD was defined as a TAPSE ≤ 16 mm or tissue Doppler-derived tricuspid lateral annular systolic velocity (S′TDI) < 10 cm/s.Hazard ratios were extracted from multivariate models reporting on the association of RVD and TR with mortality and described as pooled estimates with 95% confidence intervals. Data were pooled across studies using the DerSimonian-Laird random-effects model. Results: A total of 9 nonrandomized studies met the inclusion criteria with eight studies having at least 12 months follow-up. Among the above studies, a total of 1325 patients (74.1% being male) were eligible for being included in our meta-analysis with an overall survival of 68.2% (n = 903). Of the enrolled patients, RVD was present in 39.1% and moderate-severe TR in 32.8%. RVD was significantly associated with mortality compared to normal RV function (HR, 1.89, 95% CI, 1.51-2.38, p < 0.001, I2 =0). Additionally, patients with moderate-severe TR showed increased risk of mortality compared with those in the none-mild TR group (HR, 1.71. 95% CI, 1.36-2.15, p < 0.001, I2 =0) Conclusions: This meta-analysis demonstrates the prognostic importance of RVD and TR grade in predicting all-cause mortality in patients with FMR. RV function and TR parameters may therefore be useful in the risk stratification of patients with FMR.