Abstract
Little is known about how tightly right atrial pressure (RAP) is associated with prognosis in patients with severe tricuspid regurgitation (TR). The aim of this study was to investigate the association of RAP estimated by echocardiography (RAP-echo) with cardiovascular events in patients with severe TR. We retrospectively studied 240 outpatients (median 75 years, 130 female) who underwent 2-dimensional transthoracic echocardiography and were diagnosed with severe TR. According to RAP-echo using the diameter of inferior vena cava and its response to a sniff, patients were classified into 2 groups: low/middle and high RAP-echo. Cardiovascular events were defined as cardiovascular death or admission for heart failure. During follow-up (median, 428 [87-1229] days), 64 patients experienced a cardiovascular event. By multivariate analysis, high RAP-echo was independently associated with cardiovascular events (hazard ratio, 2.46 [1.17 - 5.18]). Also, jugular vein distention and leg edema were not independently associated with cardiovascular events. The significant and stronger association of RAP-echo with clinical outcome compared to estimates of RAP on physical examination suggests that recognition of high RAP-echo can be a valuable surrogate for the clinical management of severe TR patients.
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