Quantitative Identification of High-Risk Tricuspid Regurgitation by Cardiac Magnetic Resonance

作者：Davide Margonato, Maurice Enriquez‐Sarano, Takahiro Nishihara, Asa Phichaphop, Ellen Cravero, Cheng Wang, Miho Fukui, Paul Sorajja, John R. Lesser, Erik B. Schelbert, Eustachio Agricola, Francesco Maisano, Philipp Lurz, Fabien Praz, Jörg Hausleiter, Patrizio Lancellotti, Rebecca T. Hahn, Vinayak Bapat, João L. Cavalcante · 发表于：Circulation · 年份：2025 · DOI：10.1161/circulationaha.125.074862 · 被引用次数：10 · 研究领域：Cardiac Valve Diseases and Treatments、Cardiac Imaging and Diagnostics、Pulmonary Hypertension Research and Treatments

BACKGROUND: The role of cardiac magnetic resonance (CMR) quantification of tricuspid regurgitation (TR) to identify high-risk patients with TR remains poorly defined. The aim of this study was to assess the prognostic relevance of TR quantification and of its consequences by CMR in a large real-world cohort. METHODS: Comprehensive clinical, echocardiographic, and CMR data were collected from patients referred to clinical CMR between 2019 and 2024 and who had TR quantification using tricuspid regurgitant fraction (TRF) and parametric mapping analysis for liver extracellular volume (L-ECV). The primary end point was the composite of all-cause mortality and heart failure hospitalization, both under medical management accounting for the timing of tricuspid intervention for those that received it; the secondary outcome was all-cause mortality. RESULTS: In the 489 patients (median age, 68 years; 41% women) included into this retrospective observational study, median TRF was 21% (interquartile range, 14%–33%). Relative hazard of the composite end point analysis identified TRF thresholds of ≥20% and ≥40% as associated with increased hazard ratios >1 and >2 of the primary outcome, respectively. During a median follow-up of 2.3 years, Kaplan-Meier curves showed that survival free from both outcomes was inversely associated with increasing TRF severity ( P <0.001). A TRF≥40% independently predicted both end points after multivariable adjustment. Among 371 with liver mapping dat...