Association between tricuspid regurgitation and heart failure outcomes: A meta-analysis

Abstract

This study aimed to perform a systematic meta-analysis to investigate how varying severities of tricuspid regurgitation (TR) affect mortality in patients with heart failure (HF). PubMed, Web of Science, Embase and the Cochrane Library were searched up to March 2024. Heterogeneity and sensitivity analyses as well as subgroup analyses were carried out using Stata (15.1). In total, 12 cohort studies involving 45 829 HF patients were included. The meta-analysis demonstrated that the TR group exhibited notably higher all-cause mortality [risk ratio (RR) = 1.15, 95% confidence interval (CI): 1.02-1.29, P < 0.05] and HF rehospitalization rate (RR = 1.24, 95% CI: 1.13-1.36, P < 0.001) than the non-TR group. Subgroup analysis by the severity of TR indicated that all-cause mortality (RR = 1.34, 95% CI: 1.10-1.63, P < 0.05), HF rehospitalization rate (RR = 1.30, 95% CI: 1.16-1.45, P < 0.001) and cardiovascular mortality (RR = 1.49, 95% CI: 1.04-2.15, P < 0.05) were notably higher in the moderate/severe TR group than in the non-TR/mild TR group. Subgroup analysis showed that ejection fraction, region, regression methods and publication year affected the results of both groups. Moderate and severe TR can increase the risk of all-cause mortality and HF rehospitalization rate. However, these results may be influenced by other factors. More studies on the prognosis of HF patients with different ejection fractions and regions are desired to further validate and improve our findings.

Keywords: heart failure; meta‐analysis; prognosis; tricuspid regurgitation.

Figure 1

Flow chart of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses.

Figure 2

Meta‐analysis on the prognosis of heart failure (HF) patients with moderate/severe tricuspid regurgitation (TR) and non‐TR/mild TR. (A) All‐cause mortality. (B) Cardiovascular mortality. (C) HF rehospitalization rate. CI, confidence interval; RR, risk ratio.