{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:02:11Z","timestamp":1793271731539,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,1,3]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The natural history and optimal interventional timing in patients with isolated severe tricuspid regurgitation (TR) have not been well studied. This study aimed to investigate long\u2010term clinical outcomes and risk factors associated with poor prognosis in patients with isolated severe TR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Consecutive transthoracic echocardiographic examinations in 2877 patients with isolated severe TR were retrospectively reviewed. Patients with significant left\u2010sided valve disease or repeated examinations were excluded. Primary outcome was defined as a composite of all\u2010cause death and hospitalization for heart failure. Among the 613 enrolled patients (mean age, 74\u00b113\u2009years; men, 38%), 141 died, and 62 were hospitalized for heart failure during the median follow\u2010up period of 26.5 (interquartile range, 6.0\u201357.9) months. The 5\u2010year event\u2010free rate was 60.1%. TR pressure gradient (adjusted hazard ratio [HR], 1.03 [95% CI, 1.01\u20131.04]), blood urea nitrogen (adjusted HR, 1.02 [95% CI, 1.01\u20131.04]), left atrial volume index (adjusted HR, 1.01 [95% CI, 1.002\u20131.02]), and serum albumin (adjusted HR, 0.56 [95% CI, 0.36\u20130.95]) were identified as independent predictors of adverse events. A risk model based on the 4 clinical factors that included pulmonary hypertension (TR pressure gradient &gt;40\u2009mm\u2009Hg), elevated blood urea nitrogen levels (&gt;25\u2009mg\/dL), decreased albumin levels (&lt;3.7\u2009g\/dL), and left atrial enlargement (left atrial volume index &lt;34\u2009mL\/m\n              <jats:sup>2<\/jats:sup>\n              ) revealed a graded increase in the risk of adverse events (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The prognosis of isolated severe TR is not always favorable. Careful attention should be paid to patients with concomitant risk factors, such as pulmonary hypertension, elevated blood urea nitrogen levels, decreased albumin levels, and left atrial enlargement.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.025751","type":"journal-article","created":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T10:31:34Z","timestamp":1671877894000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Long\u2010Term Clinical Outcomes in Patients With Severe Tricuspid Regurgitation"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0440-9351","authenticated-orcid":false,"given":"Naoki","family":"Nishiura","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Kobe City Medical Center General Hospital Kobe 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