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      The need for a new tricuspid regurgitation grading scheme

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      European Heart Journal - Cardiovascular Imaging
      Oxford University Press (OUP)

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          Most cited references15

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          Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance.

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            Impact of tricuspid regurgitation on long-term survival.

            The goal of this study was to examine mortality associated with tricuspid regurgitation (TR) after controlling for left ventricular ejection fraction (LVEF), right ventricular (RV) dilation and dysfunction, and pulmonary artery systolic pressure (PASP). Tricuspid regurgitation is a frequent echocardiographic finding; however, the association with prognosis is unclear. We retrospectively identified 5,223 patients (age 66.5 +/- 12.8 years; predominantly male) undergoing echocardiography at one of three Veterans Affairs Medical Center laboratories over a period of four years. Follow-up data were available for four years (mean 498 +/- 402 days). Kaplan-Meier and proportional hazards methods were used to compare differences in survival among TR grades. Mortality increased with increasing severity of TR. The one-year survival was 91.7% with no TR, 90.3% with mild TR, 78.9% with moderate TR, and 63.9% with severe TR. Moderate or greater TR was associated with increased mortality regardless of PASP (hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.16 to 1.49 for PASP >40 mm Hg; HR 1.32, 95% CI 1.05 to 1.62 for PASP or =50%). When adjusted for age, LVEF, inferior vena cava size, and RV size and function, survival was worse for patients with moderate (HR 1.17, 95% CI 0.96 to 1.42) and severe TR (HR 1.31, 95% CI 1.05 to 1.66) than for those with no TR. We conclude that increasing TR severity is associated with worse survival in men regardless of LVEF or pulmonary artery pressure. Severe TR is associated with a poor prognosis, independent of age, biventricular systolic function, RV size, and dilation of the inferior vena cava.
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              2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.

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                Author and article information

                Journal
                European Heart Journal - Cardiovascular Imaging
                Oxford University Press (OUP)
                2047-2404
                2047-2412
                December 2017
                December 01 2017
                July 13 2017
                December 2017
                December 01 2017
                July 13 2017
                : 18
                : 12
                : 1342-1343
                Article
                10.1093/ehjci/jex139
                28977455
                ac38f02e-1cef-43e5-95c4-cda1973df5d2
                © 2017
                History

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