Echocardiographic Characteristics of Heart Failure Patients with Severe Tricuspid Regurgitation

Abstract

Introduction The proportion of patients with heart failure (HF) and severe tricuspid regurgitation (TR) that are potential candidates for a percutaneous tricuspid valve intervention is unknown. The aim of this study was to evaluate in a real-world setting the echocardiographic characteristics of Heart Failure HF patients with severe TR. Methods This was a retrospective cohort study of 2133adult patients enrolled in the HF clinic at the McGill University Health Center from 2007 to 2017, totaling 10 300 echocardiograms. Included in our study were patientswith a clinical diagnosis of HF and available echocardiographic follow up. All data after heart transplant or ventricular assist device was excluded. The severity of TR was classified according to the American Society of Echocardiography guidelines. All patients who never had severe TR during their follow-up were included in the control group. Results There were 321 patients with severe TR at any time during the follow-up period (mean age 66±16 years; 61% male), whereas 1812 patients did not have severe TR (mean age 60±15 years; 60% male). Among patients with severe TR, left ventricular ejection fraction (LVEF) was low (≤50%) in 76%, compared to the control group in which LVEF was low in 71% (p=0.07). Severe mitral regurgitation (MR) was present in 26% of the severe TR group compared to 5% in the control group (p 50mmHg) was present in 53% of the severe TR group, compared to 20% in control group (p Conclusions In patients with HF, severe TR is associated with worse echocardiographic parameters including severe MR, pulmonary hypertension, RV dilatation and RV systolic dysfunction. Half of patients with severe TR could be eligible for tricuspid valve intervention.