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

Jeong, Hyeonju; Song, Seungkeun; Seo, Jiwon; Cho, Iksung; Hong, Geu Ru; Ha, Jong Won; Shim, Chi Young

doi:10.1002/ehf2.12906

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Previous studies demonstrated that LVEF reduction, 15 atrial arrhythmias, 31 and presence of moderate to severe TR 32 had an adverse impact on HF progression. In our study, first-degree AVB showed a significant relation with HF outcomes, which was consistent with another study.…”

Section: Prior Studies On Risk Predictionmentioning

confidence: 96%

Novel Risk Prediction Model to Determine Adverse Heart Failure Outcomes in Arrhythmogenic Right Ventricular Cardiomyopathy

Chen

Saguner

et al. 2022

JAHA

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Background Patients with arrhythmogenic right ventricular cardiomyopathy are at risk for life‐threatening ventricular tachyarrhythmias, but progressive heart failure (HF) may occur in later stages of disease. This study aimed to characterize potential risk predictors and develop a model for individualized assessment of adverse HF outcomes in arrhythmogenic right ventricular cardiomyopathy. Methods and Results Longitudinal and observational cohorts with 290 patients with arrhythmogenic right ventricular cardiomyopathy from the Fuwai Hospital in Beijing, China, and 99 patients from the University Heart Center in Zurich, Switzerland, with follow‐up data were studied. The primary end point of the study was heart transplantation or death attributable to HF. The model was developed by Cox regression analysis for predicting risk and was internally validated. During 4.92±3.03 years of follow‐up, 48 patients reached the primary end point. The determinants of the risk prediction model were left ventricular ejection fraction, serum creatinine levels, moderate‐to‐severe tricuspid regurgitation, and atrial fibrillation. Implantable cardioverter‐defibrillators did not reduce the occurrence of adverse HF outcomes. Conclusions A novel risk prediction model for arrhythmogenic right ventricular cardiomyopathy has been developed using 2 large and well‐established cohorts, incorporating common clinical parameters such as left ventricular ejection fraction, serum creatinine levels, tricuspid regurgitation, and atrial fibrillation, which can identify patients who are at risk for terminal HF events, and may guide physicians to assess individualized HF risk and to optimize management strategies.

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Section: Prior Studies On Risk Predictionmentioning

confidence: 96%

Novel Risk Prediction Model to Determine Adverse Heart Failure Outcomes in Arrhythmogenic Right Ventricular Cardiomyopathy

Chen

Saguner

et al. 2022

JAHA

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“…29 Regarding valvular assessment, tricuspid regurgitation is associated with poor prognosis. 30,31 There are limited data regarding surgical correction of functional tricuspid regurgitation in patients with ARVC; however, a case series of 3 patients suggested it could have a therapeutic role in selected patients. 32 In addition to decreased RV-FAC, as identified by the 2010 Task Force Criteria, 2 other indices of right ventricular dysfunction have been reported.…”

Section: Echocardiographymentioning

confidence: 99%

Multimodality Imaging in Arrhythmogenic Right Ventricular Cardiomyopathy

Malik

Mukherjee

et al. 2022

Circ: Cardiovascular Imaging

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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare, heritable myocardial disease associated with the development of ventricular arrhythmias, heart failure, and sudden cardiac death in early adulthood. Multimodality imaging is a central component in the diagnosis and evaluation of ARVC. Diagnostic criteria established by an international task force in 2010 include noninvasive parameters from echocardiography and cardiac magnetic resonance imaging. These criteria identify right ventricular structural abnormalities, chamber and outflow tract dilation, and reduced right ventricular function as features of ARVC. Echocardiography is a widely available and cost-effective technique, and it is often selected for initial evaluation. Beyond fulfillment of diagnostic criteria, features such as abnormal tricuspid annular plane excursion, increased right ventricular basal diameter, and abnormal strain patterns have been described. 3-dimensional echocardiography may also expand opportunities for structural and functional assessment of ARVC. Cardiac magnetic resonance has the ability to assess morphological and functional cardiac features of ARVC and is also a core modality in evaluation, however, tissue characterization of the right ventricle is limited by spatial resolution and low specificity for detection of pathological changes. Nonetheless, the ability of cardiac magnetic resonance to identify left ventricular involvement, offer high negative predictive value, and provide a reproducible structural evaluation of the right ventricle enhance the ability and scope of the modality. In this review, the prognostic significance of multimodality imaging is outlined, including the supplemental value of multidetector computed tomography and nuclear imaging. Strengths and weaknesses of imaging techniques, as well as future direction of multimodality assessment, are also described.

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“…Tricuspid regurgitation (TR) is a poor and independent prognostic factor for the general population and patients with various cardiac diseases. 1 , 2 , 3 , 4 , 5 With aging, the prevalence of moderate or severe TR is increasing as isolated TR with atrial fibrillation increases. 5 , 6 , 7 Clinical presentation often demonstrates a long course and can be controlled temporarily with diuretics.…”

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confidence: 99%

Validation of TRI‐SCORE for Outcome Prediction After Isolated Tricuspid Valve Surgery in Asian Patients

Kim,

Cho

et al. 2024

JAHA

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Background TRI‐SCORE was recently developed in Europe as a risk model for predicting in‐hospital death after isolated tricuspid valve surgery. We aimed to validate TRI‐SCORE in an Asian population and investigate its value for predicting long‐term outcomes. Methods and Results The TRI‐SCORE was calculated for 202 patients (65±11 years, 61% women, 81% functional tricuspid regurgitation) who underwent isolated tricuspid valve surgery for severe tricuspid regurgitation at 2 Korean centers and was based on 8 parameters: age, New York Heart Association class, right‐sided heart failure signs, furosemide daily dose, glomerular filtration rate, bilirubin, left ventricular ejection fraction, and moderate/severe right ventricular dysfunction. The primary outcome was all‐cause death during follow‐up; the secondary outcome was in‐hospital death. During a median follow‐up duration of 50 (interquartile range, 21–82) months after isolated tricuspid valve surgery, 23 (11.4%) patients experienced the primary outcome, and 7 (3.5%) patients experienced the secondary outcome. Observed all‐cause death and in‐hospital death increased by up to 50% in those with higher scores. Patients with the primary outcome had a higher TRI‐SCORE (4.5±2.4 versus 2.9±2.1; P =0.001) than those without. The TRI‐SCORE showed a significant association with the primary outcome (concordance index, 0.77, cutoff value, 4) and in‐hospital death (area under the curve, 0.84; cutoff value, 3). Using the Kaplan–Meier analysis, patients with a high TRI‐SCORE exhibited a poor outcome for all‐cause death at follow‐up (log‐rank P <0.001) and in‐hospital death (log‐rank P =0.004). Conclusions TRI‐SCORE was validated in an Asian population and helped predict long‐term outcomes after isolated tricuspid valve surgery.

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

Cited by 5 publications

References 22 publications

Novel Risk Prediction Model to Determine Adverse Heart Failure Outcomes in Arrhythmogenic Right Ventricular Cardiomyopathy

Novel Risk Prediction Model to Determine Adverse Heart Failure Outcomes in Arrhythmogenic Right Ventricular Cardiomyopathy

Multimodality Imaging in Arrhythmogenic Right Ventricular Cardiomyopathy

Validation of TRI‐SCORE for Outcome Prediction After Isolated Tricuspid Valve Surgery in Asian Patients

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