Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w

Prognostic Impact of Tricuspid Regurgitation on the Outcome of Patients with Cardiogenic Shock

M. Ruka1, J. Rusnak1, T. Schupp1, K. J. Weidner1, S. Egner-Walter1, J. Forner1, T. Bertsch2, M. Kittel3, K. A. Mashayekhi4, P. Tajti5, M. Ayoub6, M. Behnes1, I. Akin1

1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg Nord, Nürnberg; 3Institut für klinische Chemie, Universitätsmedizin Mannheim (UMM), Mannheim; 4Innere Medizin und Kardiologie, MediClin Herzzentrum Lahr/Baden, Lahr/Schwarzwald; 5Gottsegen György National Cardiovascular Center, Budapest, HU; 6Allgemeine und Interventionelle Kardiologie/Angiologie, Herz- und Diabeteszentrum NRW, Bad Oeynhausen;

Objective: The study investigates the prognostic impact of tricuspid regurgitation (TR) in patients with cardiogenic shock (CS).   Background: TR is associated with adverse prognosis in various patient populations. However, data regarding the prognostic impact in patients with CS is limited.   Methods: Consecutive patients with CS from June 2019 to Mai 2021 were included monocentrically. Medical history including echocardiographic parameters were documented for each patient. TR was stratified according to severity (mild vs. moderate vs. severe). The prognostic value of prior documented severity of TR was tested in the group of patient with and without acute myocardial infarction (AMI). Statistical analyses included univariable t-test, Spearman´s correlation, Kaplan-Meier analyses, as well as uni- and multivariable Cox proportional regression analyses.   Results: 105 patients with CS and previously diagnosed TR were included. In Kaplan Meier analysis prior moderate or severe TR was associated with higher 30-day all-cause mortality in CS-patients without AMI (39 % vs. 64 %; log rank p = 0.027), whereas no significant difference could be seen in CS-patients with AMI (55 % vs. 50 %; log rank p = 0.823). This finding was confirmed in the multivariable COX regression, in which prior moderate or severe TR was solely associated with 30-day all-cause mortality in CS-patients without AMI (HR = 2.378; 95 % CI 1.121 – 5.046; p = 0.024), whereas no significant association could be seen in the AMI group (HR = 0.680; 95 % CI 0.198 – 2.335; p = 0.540).   Conclusion: Prior moderate to severe TR was independently associated with increased 30-day all-cause mortality in CS-patients without AMI, whereas no association could be seen in CS-patients with AMI.

https://dgk.org/kongress_programme/jt2023/aP2126.html