JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Association of echocardiographic diastolic tricuspid regurgitation with other echocardiographic parameters, survival scores and functional capacity in patients with advanced functional mitral regurgitation
Abstract
Aims: Functional mitral regurgitation (FMR) is an important condition associated with advanced heart failure and poor prognosis. The aim of this study was to investigate the effects of diastolic (presystolic) tricuspid regurgitation (DTR) on right ventricular function, survival rates and functional capacity in patients with advanced FMR. The relationship between DTR and right ventricular systolic function and the predictive factors involved in its development were also evaluated.
Methods: The study included 64 patients with advanced FMR who were evaluated for mitraclip therapy between June 2014 and February 2015. Demographic characteristics, cardiovascular risk factors, New York Heart Association (NYHA) functional classification and laboratory data were recorded. Left and right ventricular parameters were examined by echocardiography, and the diagnosis of DTR was made by color Doppler method. Estimated survival rates were evaluated using the Seattle Heart Failure Model Score (SHFSM) with 1- and 5-year projections.
Results: DTR was detected in 14 (22%) of the patients included in the study. The majority (85.7%) of the patients in the group with DTR were in NYHA III-IV stage and had low functional capacity. DTR showed significant assocation with right ventricular fractional area change (RV FAC), right ventricular peak systolic myocardial velocity (RV Sm), TAPSE, tricuspid regurgitation, ejection fraction, pulmonary artery systolic pressure, and pulmonary vascular resistance (p<0.05). In addition, DTR group had lower estimated survival rates compared to SHFSM (1-year estimated survival 64%, 5-year estimated survival 35%; p<0.001). In Binary Logistic Regression Analysis, RV FAC and RV Sm values were found to be independent predictors for the development of DTR.
Conclusion: DTR is an important echocardiographic parameter that indicates poor prognosis in patients with advanced FMR. This study demonstrated that DTR is associated with right ventricular dysfunction and decreased estimated survival rates. Early diagnosis of DTR may provide an important contribution to clinical management and prognostic evaluation in this patient group.

Keywords : Functional mitral regurgitation, diastolic tricuspid regurgitation, survival rate, functional capacity

Download Article


1. Hadjadj S, Marsit O, Paradis JM, Beaudoin J. Pathophysiology, diagnosis, and new therapeutic approaches for ischemic mitral regurgitation. Can J Cardiol. 2021;37(7):968-979. doi:10.1016/j.cjca.2020.12.011
2. Fan Q, Li X, Cao G, Yu P, Zhang F. Outcome of mitral valve repair or replacement for non-ischemic mitral regurgitation: a systematic review and meta-analysis. J Cardiothorac Surg. 2021;16(1):175. doi:10.1186/s13019-021-01563-2
3. Giustino G, Camaj A, Kapadia SR, et al. Hospitalizations and mortality in patients with secondary mitral regurgitation and heart failure: the coapt trial. J Am Coll Cardiol. 2022;80(20):1857-1868. doi:10.1016/j.jacc. 2022.08.803
4. Naser JA, Harada T, Tada A, et al. Prevalence, incidence, and outcomes of diastolic dysfunction in isolated tricuspid regurgitation: Perhaps not really &ldquo;isolated&rdquo;? JACC Cardiovasc Imaging. 2024;17(12):1411-1424. doi: 10.1016/j.jcmg.2024.05.019
5. Cocianni D, Stolfo D, Perotto M, et al. Association of tricuspid regurgitation with outcome in acute heart failure. Circ Cardiovasc Imaging. 2023;16(7):566-576. doi:10.1161/CIRCIMAGING.122.014988
6. Toldo C, Puga S, Kairuz P. Diastolic mitral and tricuspid insufficiency in complete atrioventricular block. Series Cardiol Res. 2022;4(1):17-18.
7. Chorin E, Rozenbaum Z, Topilsky Y, et al. Tricuspid regurgitation and long-term clinical outcomes. Eur Heart J Cardiovasc Imaging. 2020;21(2): 157-165. doi:10.1093/ehjci/jez216
8. Murayama M, Iwano H, Tsujinaga S, et al. Tricuspid regurgitation occurring in the early-diastolic phase in a case of heart failure: insights from echocardiographic and invasive hemodynamic findings. Echocardiography. 2019;36(9):1771-1775. doi:10.1111/echo.14458
9. Mitchell C, Rahko PS, Blauwet LA, et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the american society of echocardiography. Am Soc Echocardiogr. 2019;32(1):1-64. doi:10.1016/j.echo.2018.06.004
10. Szymanski P, Lipczynska M, Klisiewicz A, Hoffman P. Clinical settings leading to presystolic tricuspid regurgitation. Echocardiography. 2015; 32(1):19-27. doi:10.1111/echo.12604
11. Truong VT, Ngo TN, Mazur J, et al. Right ventricular dysfunction and tricuspid regurgitation in functional mitral regurgitation. ESC Heart Fail. 2021;8(6):4988-4996. doi:10.1002/ehf2.13558
12. Doldi PM, Stolz L, Kalbacher D, et al. Right ventricular dysfunction predicts outcome after transcatheter mitral valve repair for primary mitral valve regurgitation. Eur J Heart Fail. 2022;24(11):2162-2171. doi: 10.1002/ejhf.2661
13. Dong Y, Pan Z, Wang D, Lv J, Fang J, Xu R, et al. Prognostic value of cardiac magnetic resonance-derived right ventricular remodeling parameters in pulmonary hypertension: a systematic review and meta-analysis. Circ Cardiovasc Imaging. 2020;13(7):e010568. doi:10.1161/CIRCIMAGING.120.010568
14. Graziani F, Lillo R, Panaioli E, et al. Prognostic significance of right ventricular hypertrophy and systolic function in anderson-fabry disease. ESC Heart Fail. 2020;7(4):1605-1614. doi:10.1002/ehf2.12712
15. Shah AM, Cikes M, Prasad N, et al. Echocardiographic features of patients with heart failure and preserved left ventricular ejection fraction. JACC.2019;74(23):2858-2873
16. Lyhne MD, Kabrhel C, Giordano N, et al. The echocardiographic ratio tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure predicts short-term adverse outcomes in acute pulmonary embolism. Eur Heart J Cardiovasc Imaging. 2021;22(3):285-294. doi:10. 1093/ehjci/jeaa243
17. Dini FL, Conti U, Fontanive P, et al. Right ventricular dysfunction is a major predictor of outcome in patients with moderate to severe mitral regurgitation and left ventricular dysfunction. Am Heart J. 2007;154(1): 172-179. doi:10.1016/j.ahj.2007.03.033
18. Karam N, Stolz L, Orban M, et al. Impact of right ventricular dysfunction on outcomes after transcatheter edge-to-edge repair for secondary mitral regurgitation. JACC Cardiovasc Imaging. 2021;14(4):768-778. doi: 10.1016/j.jcmg.2020.12.015
Article available in :
Volume 3, Issue 1, 2025
Page : 10-13
https://doi.org/10.51271/JCCVS-0049
Article Information
Received : 11 Oca 2025
Accepted : 17 Mar 2025
Published : 27 Mar 2025
Corresponding Author :

Muhammet Tellice: Department of Cardiology, Kartal Koşuyolu High Specialization Training and Research Hospital, İstanbul, Turkiye

[email protected]
Citation : Tellice M, Fidan S, Avcı A, Esen AM. Association of echocardiographic diastolic tricuspid regurgitation with other echocardiographic parameters, survival scores and functional capacity in patients with advanced functional mitral regurgitation. J Cardiol Cardiovasc Surg. 2025;3(1):10-13.

Read: 82
Cited: 0
Download : 50
_Footer