Dannenberg Varius, Zschocke Flora, Halavina Kseniya, Mascherbauer Katharina, Heitzinger Gregor, Koschutnik Matthias, Donà Carolina, Nitsche Christian, Kammerlander Andreas A, Spinka Georg, Winter Max-Paul, Bartko Philipp E, Hengstenberg Christian, Bergler-Klein Jutta, Goliasch Georg, Schneider-Reigbert Matthias
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Eur J Clin Invest. 2025 Mar;55(3):e14367. doi: 10.1111/eci.14367. Epub 2024 Dec 2.
Severe tricuspid regurgitation (TR) is associated with high morbidity and mortality. Isolated TR, defined as TR without overt heart disease, is typical and offers limited cardiac treatment options other than interventional repair or replacement. Survival history of cancer or active cancer treatment may lead to an unnecessary delay of TR treatment.
We included all patients diagnosed with severe TR at the Medical University of Vienna between 2003 and 2016 who had normal left ventricular function and no other valvular lesions. Outcome analysis was performed on cancer type, status and the number of organs affected by cancer.
A total of 973 patients were included. 182 (19%) patients had cancer, 52 were active and 130 had a history of cancer at the time of TR diagnosis. Oncologic patients were divided into subgroups of gastrointestinal, skin, glands, gynaecological, breast, urogenital, lung and other cancers. Ten-year mortality of patients with cancer was higher than those without cancer (p < 0.001). Multivariate analysis adjusting for age did not reveal significantly higher mortality in patients with a history of cancer compared to patients without cancer (p = 0.59). Patients with lung, active, or multi-organ cancer showed the highest mortality.
Mortality in patients with severe isolated TR is high and increased by active or multi-organ cancer but not by a history of cancer. These patients should be discussed in interdisciplinary cardio-oncology teams to avoid delaying life-saving treatment of TR and cancer.
严重三尖瓣反流（TR）与高发病率和死亡率相关。孤立性TR定义为无明显心脏病的TR，较为典型，除介入修复或置换外，心脏治疗选择有限。癌症生存史或积极的癌症治疗可能导致TR治疗不必要的延迟。
我们纳入了2003年至2016年间在维也纳医科大学被诊断为严重TR且左心室功能正常且无其他瓣膜病变的所有患者。对癌症类型、状态以及受癌症影响的器官数量进行了结果分析。
共纳入973例患者。182例（19%）患者患有癌症，52例为现患癌症，130例在TR诊断时有癌症病史。肿瘤患者被分为胃肠道、皮肤、腺体、妇科、乳腺、泌尿生殖系统、肺部和其他癌症亚组。癌症患者的10年死亡率高于无癌症患者（p<0.001）。调整年龄后的多变量分析显示，有癌症病史的患者与无癌症病史的患者相比，死亡率没有显著升高（p=0.59）。肺癌、现患癌症或多器官癌症患者的死亡率最高。
严重孤立性TR患者的死亡率很高，现患癌症或多器官癌症会增加死亡率，但癌症病史不会。应在跨学科心脏肿瘤学团队中对这些患者进行讨论，以避免延迟TR和癌症的挽救生命治疗。
