Background

Tricuspid regurgitation (TR) is associated with negative outcomes. There are few data on factors influencing TR progression and patient follow-up after TR is discovered.

Methods

A retrospective cohort study on patients with less than severe TR was conducted from August 2018 to December 2021 to identify predictors of 1) disease progression to severe TR and 2) presence of follow-up echo. Patients were followed up from their first (index) echo with TR up until June 2023. Data were collected using Cardiac Intelligence (Mpirik, Tempus Labs Inc.). Multivariate Cox proportional hazards model examined the association between predictors and disease progression.

Results

A total of 33,108 patients with TR (27,107 mild, 2,517 mild–moderate, 2,851 moderate, 633 moderate–severe) were included in the study (min/max/average observation times: 521/1,769/1,060 days). A total of 10,696 (32%) had a follow-up echo that allowed assessment of disease progression (average time to follow-up 570 days; range: 31-1,743 days); 306 (2.9% of 10,696) eventually progressed to severe TR. Progression to severe TR was dependent on the index TR severity.

Conclusion

These findings highlight the importance of comprehensive risk assessment and raise concerns about under-recognition and lack of data regarding algorithmic TR follow-up and potential sex disparities in TR management and follow-up.

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