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Observational Study
. 2023 Jul;25(7):1061-1071.
doi: 10.1002/ejhf.2929. Epub 2023 Jun 26.

Prevalence, clinical characteristics and outcomes of heart failure patients with or without isolated or combined mitral and tricuspid regurgitation: An analysis from the ESC-HFA Heart Failure Long-Term Registry

Marianna Adamo  1 , Ovidiu Chioncel  2 , Lina Benson  3 , Bahira Shahim  3 , Maria G Crespo-Leiro  4 , Stefan D Anker  5 , Andrew J S Coats  6 , Gerasimos Filippatos  7 , Mitja Lainscak  8 , Theresa McDonagh  9 , Alexander Mebazaa  10 , Massimo F Piepoli  11 , Giuseppe M C Rosano  12 , Frank Ruschitzka  13 , Gianluigi Savarese  3 , Petar Seferovic  14 , Angiza Shahim  3 , Bogdan A Popescu  2 , Bernard Iung  15 , Maurizio Volterrani  16 , Aldo P Maggioni  17 , Marco Metra  1 , Lars H Lund  3
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Free article
Observational Study

Prevalence, clinical characteristics and outcomes of heart failure patients with or without isolated or combined mitral and tricuspid regurgitation: An analysis from the ESC-HFA Heart Failure Long-Term Registry

Marianna Adamo et al. Eur J Heart Fail. 2023 Jul.
Free article

Erratum in

Abstract

Aim: Mitral regurgitation (MR) and tricuspid regurgitation (TR) are common in patients with heart failure (HF). The aim of this study was to investigate prevalence, clinical characteristics and outcomes of patients with or without isolated or combined MR and TR across the entire HF spectrum.

Methods and results: The ESC-HFA EORP HF Long-Term Registry is a prospective, multicentre, observational study including patients with HF and 1-year follow-up data. Outpatients without aortic valve disease were included and stratified according to isolated or combined moderate/severe MR and TR. Among 11 298 patients, 7541 (67%) had no MR/TR, 1931 (17%) isolated MR, 616 (5.5%) isolated TR and 1210 (11%) combined MR/TR. Baseline characteristics were differently distributed across MR/TR categories. Compared to HF with reduced ejection fraction, HF with mildly reduced ejection fraction was associated with a lower risk of isolated MR (odds ratio [OR] 0.69; 95% confidence interval [CI] 0.60-0.80), and distinctly lower risk of combined MR/TR (OR 0.51; 95% CI 0.41-0.62). HF with preserved ejection fraction (HFpEF) was associated with a distinctly lower risk of isolated MR (OR 0.42; 95% CI 0.36-0.49), and combined MR/TR (OR 0.59; 95% 0.50-0.70), but a distinctly increased risk of isolated TR (OR 1.94; 95% CI 1.61-2.33). All-cause death, cardiovascular death, HF hospitalization and combined outcomes occurred more frequently in combined MR/TR, isolated TR and isolated MR versus no MR/TR. The highest incident rates were observed in isolated TR and combined MR/TR.

Conclusion: In a large cohort of outpatients with HF, prevalence of isolated and combined MR and TR was relatively high. Isolated TR was driven by HFpEF and was burdened by an unexpectedly poor outcome.

Keywords: Heart failure; Left ventricular ejection fraction; Mitral regurgitation; Tricuspid regurgitation.

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References

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