Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct;7(5):2933-2940.
doi: 10.1002/ehf2.12906. Epub 2020 Jul 22.

Characteristics and prognostic implications of tricuspid regurgitation in patients with arrhythmogenic cardiomyopathy

Hyeonju Jeong  1 , Shinjeong Song  2 , Jiwon Seo  2 , Iksung Cho  2 , Geu-Ru Hong  2 , Jong-Won Ha  2 , Chi Young Shim  2
Affiliations

Characteristics and prognostic implications of tricuspid regurgitation in patients with arrhythmogenic cardiomyopathy

Hyeonju Jeong et al. ESC Heart Fail. 2020 Oct.

Abstract

Aims: Arrhythmogenic cardiomyopathy (AC) is characterized by right ventricular (RV) dilatation and dysfunction and is often seen in combination with tricuspid regurgitation (TR). The aim of this study was to investigate the characteristics and prognostic implications of TR in patients with AC.

Methods and results: Clinical, echocardiographic, and cardiac magnetic resonance data of 52 patients with AC fulfilling 2010 Task Force criteria in a single centre were retrospectively evaluated. TR in AC was classified as no/mild, moderate, or severe on the basis of the current guidelines. Significant TR was defined as at least moderate TR. The primary endpoint was a composite of death, heart transplantation, and tricuspid valve surgery. There were seven patients (13.4%) with moderate TR and 13 patients (25.0%) with severe TR at initial diagnosis. Patients with severe TR showed a higher prevalence of atrial fibrillation and a higher mean NT-pro-BNP than other groups (68%, P = 0.013; 2423 ± 1578 pg/mL, P < 0.001, respectively). Patients with significant TR revealed a higher incidence of heart failure at initial presentation than did those without significant TR (30.0 vs. 3.1%, P = 0.022). Patients with severe TR showed significantly larger RV and lower RV and left ventricular functional parameters. During a mean follow-up of 4.2 years, three groups classified by TR severity considerably discriminated clinical outcomes (log rank P = 0.019). Patients with significant TR had a poorer prognosis than those with no or mild TR (42.9 vs. 3.1%, log rank P = 0.005). Cox regression analysis showed significant TR as an independent prognostic factor (hazard ratio 11.41, 95% confidential interval 1.30-99.92, P = 0.028).

Conclusions: Significant TR at initial diagnosis in patients with AC is a poor prognostic factor.

Keywords: Arrhythmogenic cardiomyopathy; Prognosis; Tricuspid regurgitation.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Initial clinical presentations of patients with arrhythmogenic cardiomyopathy (AC) according to tricuspid regurgitation (TR) severity. (A) Sudden cardiac death. (B) Ventricular arrhythmia. (C) Heart failure.
FIGURE 2
FIGURE 2
Kaplan–Meier analysis of freedom from primary endpoints. (A) Comparison in three groups classified by tricuspid regurgitation (TR) severity. (B). Comparison in two groups according to presence of significant TR.
See this image and copyright information in PMC

References

    1. Corrado D, Link MS, Calkins H. Arrhythmogenic right ventricular cardiomyopathy. N Engl J Med 2017; 376: 61–72. - PubMed
    1. Calkins H, Corrando D, Marcus F. Risk stratification in arrhythmogenic right ventricular cardiomyopathy. Circulation 2017; 136: 2068–2082. - PMC - PubMed
    1. Katritsis G, Shah AS, James CA, Murray B, Tichnell C, Judge DP, Calkins H, Tedford RJ. Surgical correction of tricuspid regurgitation in patients with ARVD/C. Heart Rhythm Case Rep 2015; 1: 326–330. - PMC - PubMed
    1. Pinamonti B, Dragos AM, Pyxaras SA, Merlo M, Pivetta A, Barbati G, Di Lenarda A, Morgera T, Mestroni L, Sinagra G. Prognostic predictors in arrhythmogenic right ventricular cardiomyopathy: results from a 10‐year registry. Eur Heart J 2011; 32: 1105–1113. - PubMed
    1. Nath J, Foster E, Hidenreich PA. Impact of tricuspid regurgitation on long‐term survival. J Am Coll Cardiol 2004; 43: 405–409. - PubMed