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- Title:
Right Heart Remodeling and Outcomes in Patients With Tricuspid Regurgitation: A Literature Review and Meta-Analysis.
- Document type:
- Journal Article; Meta-Analysis; Systematic Review
- Author(s):
- Bombace, Sara; Fortuni, Federico; Viggiani, Giacomo; Meucci, Maria Chiara; Condorelli, Gianluigi; Carluccio, Erberto; von Roeder, Maximilian; Jobs, Alexander; Thiele, Holger; Esposito, Giovanni; Lurz, Philipp; Grayburn, Paul A; Sannino, Anna
- Abstract:
- BACKGROUND: Functional tricuspid regurgitation (TR) can develop either because of right ventricular (RV) remodeling (ventricular functional TR) and/or right atrial dilation (atrial functional TR). OBJECTIVES: This meta-analysis aimed to investigate the association between right heart remodeling and long-term (>1 year) all-cause mortality in patients with significant TR (at least moderate, ≥2+). METHODS: MEDLINE, ISI Web of Science, and SCOPUS databases were searched. Studies reporting data on at least 1 RV functional parameter and long-term all-cause mortality in patients with significant TR were included. This study was designed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) requirements. RESULTS: Out of 8,902 studies, a total of 14 were included, enrolling 4,394 subjects. The duration of follow-up across the studies varied, ranging from a minimum of 15.5 months to a maximum of 73.2 months. Overall, long-term all-cause mortality was 31% (95% CI: 20%-41%; P ≤ 0.001). By means of meta-regression analyses, an inverse relation was found between tricuspid annular plane systolic excursion (11 studies enrolling 3,551 subjects, -6.3% [95% CI: -11.1% to -1.4%]; P = 0.011), RV fractional area change (9 studies, 2,975 subjects, -4.4% [95% CI: -5.9% to -2.9%]; P < 0.001), tricuspid annular dimension (7 studies, 2,986 subjects, -4.1% [95% CI: -7.6% to -0.5%]; P = 0.026), right atrial area (6 studies, 1,920 subjects, -1.9% [95% CI: -2.5% to -1.3%]; P < 0.001) and mortality. CONCLUSIONS: RV dysfunction parameters are associated to worse clinical outcomes in patients with TR, whereas right atrial dilatation is linked to a better prognostic outcome. Further studies are needed to unravel the pathophysiological differences within the functional TR spectrum. (Right heart remodeling and outcomes in patients with tricuspid regurgitation; CRD42023418667).
- Journal title abbreviation:
- JACC Cardiovasc Imaging
- Year:
- 2024
- Journal volume:
- 17
- Journal issue:
- 6
- Pages contribution:
- 595-606
- Fulltext / DOI:
- doi:10.1016/j.jcmg.2023.12.011
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/38430099
- Print-ISSN:
- 1936-878X
- TUM Institution:
- Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)
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