Background: Tricuspid regurgitation (TR) is a common finding which appears to be associated with a worse prognosis. There are conflicting data regarding the prognostic impact of mild TR. We examined the clinical characteristics and echocardiographic properties of subjects with TR and its impact on clinical outcome with particular emphasis on subjects with mild TR. Methods: Consecutive echocardiography examinations during 5 years were evaluated for TR severity and outcome including mortality and cardiovascular hospitalizations. Results: The study included 21,429 subjects; 45% of the subjects had mild TR, 15% had moderate TR and 6.5% had severe TR. Primary organic TR was evident in 7% of the subjects, a percentage that increased with increasing TR severity. TR severity was incrementally associated with older subjects with an increasing number of comorbidities and echocardiographic abnormalities. 29% of the subjects died at a median follow-up duration of 8.7 years. Increasing severity of TR was independently and incrementally associated with mortality. Subjects with mild TR had a 25% increased mortality rate compared to subjects with minimal TR (HR 1.25, 95% CI 1.12-1.39, P<0.001) after adjustment for significant clinical parameters. TR severity was also an independent incrementally graded predictor of cardiovascular hospitalization and mortality (mild TR: HR 1.23, 95% CI 1.12-1.34, P<0.001). Conclusions: TR is associated with older and sicker patients with numerous comorbidities. TR severity is a predictor of a worse clinical outcome. Mild TR was independently associated with decreased survival. TR should be considered a marker of a disease burden with a poor prognosis.


中文翻译：

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轻度三尖瓣反流：与死亡率增加独立相关的疾病负担标志

背景：三尖瓣反流（TR）是一种常见现象，似乎与较差的预后相关。关于轻度 TR 的预后影响，存在相互矛盾的数据。我们检查了 TR 受试者的临床特征和超声心动图特性及其对临床结果的影响，特别关注轻度 TR 受试者。方法：通过 5 年连续超声心动图检查评估 TR 严重程度和结果，包括死亡率和心血管住院治疗。结果：该研究纳入了 21,429 名受试者；45% 的受试者患有轻度 TR，15% 患有中度 TR，6.5% 患有重度 TR。7% 的受试者存在明显的原发性器质性 TR，该比例随着 TR 严重程度的增加而增加。TR 严重程度与老年受试者的合并症和超声心动图异常数量增加相关。29% 的受试者在中位随访时间为 8.7 年时死亡。TR 严重程度的增加与死亡率独立且递增地相关。调整重要临床参数后，与轻度 TR 受试者相比，轻度 TR 受试者的死亡率增加 25%（HR 1.25，95% CI 1.12-1.39，P<0.001）。TR 严重程度也是心血管住院和死亡率的独立增量分级预测因子（轻度 TR：HR 1.23，95% CI 1.12-1.34，P<0.001）。结论：TR 与患有多种合并症的老年且病情较重的患者相关。TR 严重程度是临床结果较差的预测指标。轻度 TR 与生存率降低独立相关。TR 应被视为预后不良的疾病负担的标志。