One-year follow-up of patients with severe tricuspid regurgitation: prognostic impact of right heart failure staging

Abstract Introduction Severe tricuspid regurgitation (STR) is associated with adverse outcomes. This nationwide registry describes the prevalence, aetiology, clinical, and echocardiographic profile of STR using contemporary classifications, and evaluates the prognostic impact of a modified right hea...

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Autores: Gómez-Polo, Juan Carlos, Gómez-Salvador, Itziar, Mahía Casado, Patricia, Pérez David, Esther, Pericas, Pere, Parada Barcia, José Antonio, Izurieta, Carlos, Revilla Orodea, Ana, Moñivas, Vanessa, Testa, Ana, Miguel, Lara, Carrión-Sánchez, Irene, Gutiérrez, Laura, Ortega Trujillo, José Ramón, Hernández Vicente, Nuria, Torres Quintero, Lucía, Zaldua Irastorza, Olatz, Delgado Ortega, Mónica, Osa Sáez, Ana, Millán, María Victoria, Pérez, María de los Ángeles, Aguilera, Almudena, Pascual, Isaac, Méndez, Irene, Abuli Lluch, Marc, Romero Delgado, Teresa, González Gómez, Ariana, del Castillo, Samuel, Martín de la Fuente, Pilar, Morillas, Pedro, Gaitán, Daniel, Mogollón, María Victoria, Payá Chaume, Ana, Bouzas, Alberto, Pérez, Jana, Sánchez, Jessica, López Cuenca, Ángel, Amao, Elvis, Fernández Camacho, José Carlos, Blasco, Teresa, Roldán, Ildefonso, Graupner, Catherine, Manzano, Carmen, Martínez Monzonis, Amparo, Ruiz Majoral, Alex, Vannini, Luca, Baquero, Mario, Rodríguez, Lizandro, Cabrera, Fernando, Rollán, María Jesús, Reyes, Raúl, Fernández Pérez, Cristina, San Román, José Alberto, Vilacosta, Isidre
Tipo de recurso: artículo
Fecha de publicación:2026
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/26775
Acceso en línea:https://hdl.handle.net/20.500.13003/26775
Access Level:acceso abierto
Palabra clave:Atrial fibrillation
Cardiovascular mortality
Right heart failure
Right ventricle
Severe tricuspid regurgitation
Descripción
Sumario:Abstract Introduction Severe tricuspid regurgitation (STR) is associated with adverse outcomes. This nationwide registry describes the prevalence, aetiology, clinical, and echocardiographic profile of STR using contemporary classifications, and evaluates the prognostic impact of a modified right heart failure staging (RHFS). Methods We prospectively enrolled consecutive patients with STR from 48 centres over 6 months and followed them for 1 year. TR severity (severe, massive, torrential) and aetiology were defined using current recommendations. A modified RHFS incorporating RV remodelling and systolic dysfunction was applied. Results We included 1247 patients (mean age 76.7 ± 10.5 years; 70.2% women): 64.9% had severe TR, 24.1% massive TR, and 11.0% torrential TR. V-STR due to left-heart disease was the most frequent aetiology (49.9%), followed by A-STR (19.8%). During follow-up, HF hospitalization occurred in 20.8%, cardiovascular death in 9.2%, and 12.3% underwent tricuspid intervention. In multivariable analysis, Stages III–IV of the modified RHFS were independently associated with HF hospitalization (HR 1.58; 95% CI 1.13–2.23; P = .008) and cardiovascular mortality (HR 2.01; 95% CI 1.27–3.18; P = .003). Massive (HR 1.72; 95% CI 1.02–2.91; P = .041) and torrential TR (HR 2.57; 95% CI 1.24–5.34; P = .011) were also associated with cardiovascular mortality. Conclusion Massive and torrential TR identify patients at the highest risk. The modified RHFS stratifies patients with STR into prognostic categories and may help guide the timing of intervention.

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