{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T23:38:44Z","timestamp":1792885124859,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atrial fibrillation is a prevalent disease with increased risk of tricuspid regurgitation (TR), which can worsen prognosis by causing right heart remodelling. Fibrosis-4 index (FIB-4), a composite marker originally developed for liver fibrosis, has been revealed of prognostic value in heart failure. We aimed to clarify the association between FIB-4 and the severity of TR as well as the prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study in a medical centre, identifying atrial fibrillation patients with complete biochemical and echocardiographic data for evaluation. Up to 4919 patients were included. The median age was 75\u2009years, 60.0% (n\u2009=\u20092952) of patients were male, 40.8% (n\u2009=\u20092008) of patients had significant mitral regurgitation, 52.1% (n\u2009=\u20092564) of patients had significant TR, and 34.4% (n\u2009=\u20091691) had both. The median level of FIB-4 was 2.33. Using multivariable regression, a positive correlation was observed between significant TR and FIB-4. With a median follow-up duration of 3.9\u2009years, mortality occurred in 2694 (54.8%) patients. The high FIB-4 group (&amp;gt;2.67) was associated with an increased risk of all-cause death (adjusted hazard ratio [aHR] 1.357, 95% confidence interval [CI] 1.183\u20131.555, p\u2009&amp;lt;\u20090.001) when compared with the low FIB-4 group (&amp;lt;1.3). In subgroup of isolated TR, high FIB-4 was also associated with significantly higher risks of all-cause mortality (aHR 1.930, 95% CI 1.330\u20132.801).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with atrial fibrillation, FIB-4 was positively associated with TR severity and an increased risk of all-cause mortality. FIB-4 serves as a simple, non-invasive tool for prognostic stratification of TR and possible surrogate marker for timely intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3761","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T03:18:23Z","timestamp":1752549503000},"page":"2292-2300","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fibrosis-4 Index Reflects the Severity of Tricuspid Regurgitation and Patient Prognosis in Atrial Fibrillation"],"prefix":"10.1093","volume":"27","author":[{"given":"Kai-Chun","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]},{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch , Hsinchu ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Tse","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Chuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Integrative Medical Database Center, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Lin","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Integrative Medical Database Center, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Chen","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cho-Kai","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Chih","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]},{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch , Hsinchu ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lung-Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"2026021721492998900_ejhf3761-bib-0001","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"2026021721492998900_ejhf3761-bib-0002","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1016\/j.jacc.2022.09.045","article-title":"Incidence and burden of tricuspid 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