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Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors
AIMS: Although significant tricuspid regurgitation (TR) is critically associated with heart failure (HF) prognosis, the predictors for large TR impact on HF outcomes remain unknown. This study aimed to identify echocardiographic predictors for a causal relation of TR to HF outcomes. METHODS AND RESU...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9241574/ https://www.ncbi.nlm.nih.gov/pubmed/35919266 http://dx.doi.org/10.1093/ehjopen/oeab027 |
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author | Hakuno, Daihiko Fukae, Tomoaki Takahashi, Masashi Sueyoshi, Koichiro |
author_facet | Hakuno, Daihiko Fukae, Tomoaki Takahashi, Masashi Sueyoshi, Koichiro |
author_sort | Hakuno, Daihiko |
collection | PubMed |
description | AIMS: Although significant tricuspid regurgitation (TR) is critically associated with heart failure (HF) prognosis, the predictors for large TR impact on HF outcomes remain unknown. This study aimed to identify echocardiographic predictors for a causal relation of TR to HF outcomes. METHODS AND RESULTS: In a retrospective, acute HF cohort of 462 patients, multivariate logistic regression analysis was performed to determine subgroups with strong association of greater-than-moderate TR with HF readmission or cardiovascular death in a year. We then conducted causal mediation analysis according to persistent atrial fibrillation (Af) or mitral regurgitation (MR) to identify the echocardiographic predictors. The association of TR with HF outcomes was prominent in subgroups of females, with Af, the enlarged indexed tricuspid annular diameter (TADi) or right atrial area, or within certain ranges of the left ventricular ejection fraction, indexed right ventricular end-systolic area, or fractional area change (FAC). Causal mediation analysis found that the TR impact was significant in patients with Af. Furthermore, combination of TADi ≥2.1 cm/m(2) and FAC ≥30%, which accounted for half of TR patients, predicted a much larger TR impact irrespective of Af and MR. Its prediction ability was superior to that of the modified Model for End-stage Liver Disease score. CONCLUSION: The causal impact and burden of TR on HF outcomes was significant in patients with Af, and combining TADi ≥2.1 cm/m(2) with FAC ≥30% could provide superior echocardiographic prediction of larger TR impact in HF patients. |
format | Online Article Text |
id | pubmed-9241574 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-92415742022-08-01 Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors Hakuno, Daihiko Fukae, Tomoaki Takahashi, Masashi Sueyoshi, Koichiro Eur Heart J Open Original Article AIMS: Although significant tricuspid regurgitation (TR) is critically associated with heart failure (HF) prognosis, the predictors for large TR impact on HF outcomes remain unknown. This study aimed to identify echocardiographic predictors for a causal relation of TR to HF outcomes. METHODS AND RESULTS: In a retrospective, acute HF cohort of 462 patients, multivariate logistic regression analysis was performed to determine subgroups with strong association of greater-than-moderate TR with HF readmission or cardiovascular death in a year. We then conducted causal mediation analysis according to persistent atrial fibrillation (Af) or mitral regurgitation (MR) to identify the echocardiographic predictors. The association of TR with HF outcomes was prominent in subgroups of females, with Af, the enlarged indexed tricuspid annular diameter (TADi) or right atrial area, or within certain ranges of the left ventricular ejection fraction, indexed right ventricular end-systolic area, or fractional area change (FAC). Causal mediation analysis found that the TR impact was significant in patients with Af. Furthermore, combination of TADi ≥2.1 cm/m(2) and FAC ≥30%, which accounted for half of TR patients, predicted a much larger TR impact irrespective of Af and MR. Its prediction ability was superior to that of the modified Model for End-stage Liver Disease score. CONCLUSION: The causal impact and burden of TR on HF outcomes was significant in patients with Af, and combining TADi ≥2.1 cm/m(2) with FAC ≥30% could provide superior echocardiographic prediction of larger TR impact in HF patients. Oxford University Press 2021-09-23 /pmc/articles/PMC9241574/ /pubmed/35919266 http://dx.doi.org/10.1093/ehjopen/oeab027 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Hakuno, Daihiko Fukae, Tomoaki Takahashi, Masashi Sueyoshi, Koichiro Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors |
title | Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors |
title_full | Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors |
title_fullStr | Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors |
title_full_unstemmed | Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors |
title_short | Causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors |
title_sort | causal relation of tricuspid regurgitation for heart failure outcomes: a mediation analysis of echocardiographic predictors |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9241574/ https://www.ncbi.nlm.nih.gov/pubmed/35919266 http://dx.doi.org/10.1093/ehjopen/oeab027 |
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