Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Department of Cardiovascular Medicine, National Hospital Organization Iwakuni Clinical Center.
Circ J. 2022 Oct 25;86(11):1777-1784. doi: 10.1253/circj.CJ-22-0109. Epub 2022 Aug 4.
The fibrosis-4 (FIB-4) index is used to evaluate liver disease patients. It can also be used to evaluate the prognosis for heart disease patients; however, its ability to determine the prognosis of severe isolated tricuspid regurgitation (TR) patients is unclear. This study aimed to clarify the association between FIB-4 index scores and the cardiovascular prognosis for severe isolated TR patients.
This was a dual-center, retrospective study. From 2011 to 2019, 111 consecutive outpatients with severe isolated TR (mean age, 68.6 years; 53.2% male) were evaluated. Major adverse cardiovascular events (MACEs) were defined as the composite of cardiovascular death, hospitalization for heart failure, myocardial infarction, and stroke. The association between FIB-4 index scores and echocardiography was also evaluated. During a median follow up of 3.0 years, 24 patients were lost to follow up and 40 MACEs occurred. Baseline FIB-4 index scores for patients with MACEs were significantly higher than those for patients without MACEs. A multivariate analysis revealed that FIB-4 index scores are significantly associated with MACEs (hazard ratio, 1.89; 95% confidence interval, 1.01-3.54; P=0.046). A linear regression analysis indicated that FIB-4 index scores were correlated with echocardiographic parameters, including the left atrial volume index and left ventricular end-diastolic diameter.
The FIB-4 index score may be a useful predictor of MACEs for patients with severe isolated TR.
纤维化 4 指数（FIB-4）用于评估肝病患者，也可用于评估心脏病患者的预后；然而，其在评估严重孤立性三尖瓣反流（TR）患者预后中的作用尚不清楚。本研究旨在明确 FIB-4 指数与严重孤立性 TR 患者心血管预后的相关性。
这是一项双中心、回顾性研究。2011 年至 2019 年，连续评估了 111 例严重孤立性 TR 患者（平均年龄 68.6 岁，53.2%为男性）。主要不良心血管事件（MACE）定义为心血管死亡、心力衰竭住院、心肌梗死和中风的复合事件。还评估了 FIB-4 指数与超声心动图之间的关系。在中位随访 3.0 年期间，有 24 例患者失访，40 例发生 MACE。发生 MACE 的患者的基线 FIB-4 指数显著高于未发生 MACE 的患者。多变量分析显示，FIB-4 指数与 MACE 显著相关（风险比 1.89，95%置信区间 1.01-3.54，P=0.046）。线性回归分析表明，FIB-4 指数与超声心动图参数（左心房容积指数和左心室舒张末期直径）相关。
FIB-4 指数可能是严重孤立性 TR 患者 MACE 的有用预测指标。
