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Characteristics and prognostic implications of tricuspid regurgitation in patients with arrhythmogenic cardiomyopathy

 Hyeonju Jeong  ;  Shinjeong Song  ;  Jiwon Seo  ;  Iksung Cho  ;  Geu-Ru Hong  ;  Jong-Won Ha  ;  Chi Young Shim 
 ESC HEART FAILURE, Vol.7(5) : 2933-2940, 2020-10 
Journal Title
Issue Date
Arrhythmogenic cardiomyopathy ; Prognosis ; Tricuspid regurgitation
Aims: Arrhythmogenic cardiomyopathy (AC) is characterized by right ventricular (RV) dilatation and dysfunction and is often seen in combination with tricuspid regurgitation (TR). The aim of this study was to investigate the characteristics and prognostic implications of TR in patients with AC. Methods and results: Clinical, echocardiographic, and cardiac magnetic resonance data of 52 patients with AC fulfilling 2010 Task Force criteria in a single centre were retrospectively evaluated. TR in AC was classified as no/mild, moderate, or severe on the basis of the current guidelines. Significant TR was defined as at least moderate TR. The primary endpoint was a composite of death, heart transplantation, and tricuspid valve surgery. There were seven patients (13.4%) with moderate TR and 13 patients (25.0%) with severe TR at initial diagnosis. Patients with severe TR showed a higher prevalence of atrial fibrillation and a higher mean NT-pro-BNP than other groups (68%, P = 0.013; 2423 ± 1578 pg/mL, P < 0.001, respectively). Patients with significant TR revealed a higher incidence of heart failure at initial presentation than did those without significant TR (30.0 vs. 3.1%, P = 0.022). Patients with severe TR showed significantly larger RV and lower RV and left ventricular functional parameters. During a mean follow-up of 4.2 years, three groups classified by TR severity considerably discriminated clinical outcomes (log rank P = 0.019). Patients with significant TR had a poorer prognosis than those with no or mild TR (42.9 vs. 3.1%, log rank P = 0.005). Cox regression analysis showed significant TR as an independent prognostic factor (hazard ratio 11.41, 95% confidential interval 1.30-99.92, P = 0.028). Conclusions: Significant TR at initial diagnosis in patients with AC is a poor prognostic factor.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Seo, Jiwon(서지원) ORCID logo https://orcid.org/0000-0002-7641-3739
Song, Shin Jeong(송신정) ORCID logo https://orcid.org/0000-0002-5789-854X
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Cho, Ik Sung(조익성)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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