Seko Yuta, Kato Takao, Shiba Masayuki, Morita Yusuke, Yamaji Yuhei, Haruna Yoshizumi, Nakane Eisaku, Haruna Tetsuya, Inoko Moriaki
Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine Kyoto Japan.
Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
Circ Rep. 2019 Dec 3;1(12):617-622. doi: 10.1253/circrep.CR-19-0112.
The aim of this study was to evaluate the association of isolated tricuspid regurgitation (TR) with long-term outcome in patients with preserved left ventricular ejection fraction (LVEF). We retrospectively analyzed 3,714 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding severe and moderate left-side valvular disease and LVEF <50%. We classified patients into 2 groups: moderate to severe TR (n=53) and no moderate to severe TR (n=3,661). Next, we generated a propensity score (PS)-matched cohort: the moderate to severe TR group and the no moderate to severe TR group (n=41 in each group). The primary outcome was a composite of all-cause death and major adverse cardiac events. In the moderate to severe TR group, patients were older, and more likely to have higher left atrial volume index and E/e' than those in the no moderate to severe TR group. In the PS-matched cohort, cumulative 3-year incidence of the primary outcome was 61.5% in the moderate to severe TR group and 24.3% in the no moderate to severe TR group (log-rank P=0.043; hazard ratio, 2.86; 95% CI: 1.37-6.37). Isolated moderate to severe TR is associated with poor clinical outcome in patients with preserved LVEF.
本研究旨在评估孤立性三尖瓣反流（TR）与左心室射血分数（LVEF）保留的患者长期预后的相关性。我们回顾性分析了2013年在一家医院基于人群中接受了经胸超声心动图和心电图检查的3714例患者，排除了重度和中度左侧瓣膜疾病以及LVEF<50%的患者。我们将患者分为两组：中度至重度TR组（n=53）和无中度至重度TR组（n=3661）。接下来，我们生成了倾向评分（PS）匹配队列：中度至重度TR组和无中度至重度TR组（每组n=41）。主要结局是全因死亡和主要不良心脏事件的复合结局。在中度至重度TR组中，患者年龄较大，与无中度至重度TR组相比，更有可能具有更高的左心房容积指数和E/e'。在PS匹配队列中，中度至重度TR组主要结局的累积3年发生率为61.5%，无中度至重度TR组为24.3%（对数秩检验P=0.043；风险比，2.86；95%CI：1.37-6.37）。孤立性中度至重度TR与LVEF保留的患者不良临床结局相关。
