Clinical Impact of Renal Dysfunction in Patients with Severe Tricuspid Regurgitation and Chronic Heart Failure
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Renal dysfunction (RD) is common in patients with heart failure (HF), however its impact on clinical outcomes in patients with tricuspid regurgitation (TR) and HF is still debated; therefore, we aimed to assess the impact of RD on clinical outcomes in this population. Methods: All patients with HF and a prevalent or incident diagnosis of TR presenting at two centers between January 2020 and July 2021 were enrolled, in both acute (in-hospitalized patients) and chronic settings (outpatient). Patients were stratified according to the degree of RD (Group 1 <30 mL/min (n = 70), Group 2 30–59 mL/min (n = 123) and Group 3 ≥60 mL/min (n = 56). Results: Out of 249 patients, those with severe RD had lower left ventricular ejection fraction (41.8 ± 13.1% vs. 45.7 ± 14.2% vs. 48.6 ± 13.1%, p = 0.020) and tricuspid annular plane systolic excursion (16.6 ± 3.7 mm vs. 17.6 ± 4.0 mm vs. 20.0 ± 4.4 mm, p < 0.001) while brain natriuretic peptides levels were higher (979 ± 1514 pg/mL vs. 490 ± 332 pg/mL vs. 458 ± 543 pg/mL, p = 0.049) than in the other subgroups. After a median follow-up of 279 (interquartile range, IQR 195–481) days, all-cause mortality was higher in patients with severe RD (37.7% vs. 23.3% vs. 13.7%, p = 0.012). HF hospitalizations (32.7% vs. 31.2% vs. 30.6%, p = 0.970) and the composite of all-cause mortality or HF hospitalization (54.1% vs. 47.9% vs. 42.0%, p = 0.444) did not differ between subgroups. Conclusions: Severe RD is highly present in patients with HF and TR and is associated with increased incidence of all-cause mortality.
DOI: 10.31083/rcm26080
Authors: Beniamino Rosario Pagliaro, Pier Pasquale Leone, Alessandro Villaschi, Francesca Pugno Vanoni, Matteo Biroli, Ferdinando Loiacono, Marta Pellegrino, Giuseppe Pinto, Marta Maccallini, Matteo Pagnesi, Giuliana Cimino, Laura Lupi, Damiano Regazzoli Lancini, Renato Maria Bragato, Giulio Stefanini, Bernhard Reimers, Daniela Pini, Marco Metra, Gianluigi Condorelli, Marianna Adamo, Antonio Mangieri, Antonio Colombo
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,200
OpenAlex ID: W4408943004