Predictors of significant tricuspid regurgitation in atrial fibrillation: a meta-analysis.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Frontiers in Cardiovascular Medicine Pub Date : 2025-03-06 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1428964

Xiuxiu Zhang, Na Zhang, Jia Fu, Dapeng Yu

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Abstract

Aims: Significant tricuspid regurgitation (TR) in atrial fibrillation (AF) patients is becoming a global issue, as it can lead to progressive right ventricular enlargement and heart failure, thereby increasing morbidity and mortality. This study aimed to evaluate potential predictors of significant TR in AF patients using open databases.

Methods: PubMed, EMBASE, the Cochrane Library, and Web of Science were searched for relevant studies from inception to September 2023. Using STATA 14.0 statistical software, hazard ratios (HRs) were calculated for data synthesis. The potential predictors included clinical characteristics, echocardiography parameters, and prior comorbidities. Evidence certainty was evaluated based on the GRADE system.

Results: In total, 12 studies involving almost 16,000 patients were included in this review. Female sex (HR = 2.14; 95% CI: 1.84-2.49; I² = 0.0%; p = 0.430), persistent atrial fibrillation (HR = 2.99; 95% CI: 2.47-3.61; I² = 0.0%; p = 0.896), left ventricular ejection fraction [standard mean difference (SMD) = -0.16; 95% CI:-0.30 to -0.03; I² = 69.8%; p < 0.000], age (HR = 1.07; 95% CI: 1.04-1.09; I² = 72.3%; p = 0.013), heart failure (HR = 1.86; 95% CI: 1.45-2.39; I² = 9.0%; p = 0.348), age ≥65 years (HR = 2.30; 95% CI: 1.63-3.25; I² = 55.1%; p = 0.108), chronic lung disease (HR = 1.33; 95% CI: 1.02-1.74; I² = 0.0%; p = 0.882), right ventricle fractional area change (SMD = 0.18; 95% CI: 0.01-0.36; I² = 0.0%; p = 0.440), systolic pulmonary arterial pressure (SMD = 0.97; 95% CI: 0.76-1.19; I² = 41.5%; p = 0.181), and proper ventricular systolic pressure (SMD = 1.07; 95% CI: 0.54-1.59; I² = 92.4%; p < 0.000) may negatively influence significant TR.

Conclusions: This meta-analysis identified a potential negative influence of several clinical characteristics, echocardiography parameters, and previous comorbidities on significant TR. However, due to the low level of certainty of evidence, our analysis can only provide some guidance to practitioners and researchers. Caution is advised, and further validation is needed.

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心房颤动显著三尖瓣反流的预测因素：一项荟萃分析。

目的：心房颤动（AF）患者的显著三尖瓣反流（TR）正成为一个全球性问题，因为它可导致进行性右心室增大和心力衰竭，从而增加发病率和死亡率。本研究旨在利用开放数据库评估AF患者显著TR的潜在预测因素。方法：检索PubMed、EMBASE、Cochrane Library和Web of Science自成立至2023年9月的相关研究。采用STATA 14.0统计软件计算风险比（hr）进行数据综合。潜在的预测因素包括临床特征、超声心动图参数和既往合并症。依据GRADE系统评估证据确定性。结果：本综述共纳入了12项研究，涉及近16000名患者。女性(HR = 2.14；95% ci: 1.84-2.49；i2 = 0.0%；p = 0.430)，持续性房颤(HR = 2.99；95% ci: 2.47-3.61；i2 = 0.0%；p = 0.896)，左室射血分数[标准均差(SMD) = -0.16；95% CI:-0.30 ~ -0.03；i2 = 69.8%；p 2 = 72.3%；p = 0.013)，心力衰竭(HR = 1.86；95% ci: 1.45-2.39；i2 = 9.0%；p = 0.348)，年龄≥65岁(HR = 2.30；95% ci: 1.63-3.25；i2 = 55.1%；p = 0.108)，慢性肺病(HR = 1.33；95% ci: 1.02-1.74；i2 = 0.0%；p = 0.882)，右心室分数面积变化(SMD = 0.18；95% ci: 0.01-0.36；i2 = 0.0%；p = 0.440)，收缩期肺动脉压(SMD = 0.97；95% ci: 0.76-1.19；i2 = 41.5%；p = 0.181)，适当心室收缩压(SMD = 1.07；95% ci: 0.54-1.59；i2 = 92.4%；结论：本荟萃分析确定了一些临床特征、超声心动图参数和既往合并症对显著TR的潜在负面影响。然而，由于证据的确定性较低，我们的分析只能为从业者和研究人员提供一些指导。建议谨慎，需要进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.