TABLE 3.
Univariate Cox regression analysis of factors related to the combined endpoint in the whole cohort and in the 2 distinct phenotypes of STR.
| Overall population (n: 210) |
Ventricular-STR (n: 155) |
Atrial-STR (n: 56) |
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| HR (CI 95%) | P | HR (CI 95%) | P | HR (CI 95%) | P | |
| Clinical factors | ||||||
| Age, years | 1.00 (0.98–1.02) | 0.472 | 1.01 (0.99–1.03) | 0.177 | 1.02 (0.96–1.09) | 0.481 |
| Body surface area, m2 | 0.99 (0.92–1.08) | 0.386 | 1.00 (0.92–1.087) | 0.971 | 0.94 (0.71–1.2) | 0.937 |
| Heart rate, bpm | 1.01 (0.99–1.02) | 0.123 | 1.03 (1.01–1.05) | 0.031 | 1.01 (0.97–1.06) | 0.778 |
| Systolic blood pressure, mmHg | 0.99 (0.98–1.02) | 0.328 | 0.99 (0.98–1.01) | 0.511 | 0.95 (0.91–1.02) | 0.209 |
| Atrial fibrillation, n(%) | 1.7 (1.03–2.88) | 0.037 | 2.38 (1.38–4.11) | 0.002 | – | – |
| NYHA functional class III-IV, n (%) | 1.38 (0.78–2.45) | 0.258 | 1.4 (0.80–2.62) | 0.217 | 1.1 (0.56–1.99) | 0.540 |
| Diabetes, n (%) | 0.73 (0.31–1.71) | 0.291 | 0.67 (0.24–1.87) | 0.441 | 1.4 (0.17–10) | 0.818 |
| Arterial hypertension, n (%) | 0.64 (0.37–1.09) | 0.252 | 0.88 (0.47–1.66) | 0.709 | 0.46 (1.00–2.10) | 0.309 |
| Chronic obstructive pulmonary disease, n (%) | 0.94 (0.43–2.05) | 0.438 | 1.36 (0.58–3.19) | 0.471 | 1.88 (0.24–14) | 0.577 |
| Ischemic heart disease, n (%) | 0.58 (0.21–1.59) | 0.625 | 1.08 (0.39–3.01) | 0.870 | 1.48 (0.39–4.01) | 0.899 |
| Previous valve surgery, n (%) | 0.88 (0.53–1.51) | 0.524 | 0.53 (0.07–3.80) | 0.524 | – | – |
| Echocardiographic parameters | ||||||
| Left heart characteristics | ||||||
| LV ejection fraction, % | 0.99 (0.96–1.01) | 0.296 | 0.99 (0.96–1.02) | 0.221 | 1.09 (0.95–1.28) | 0.221 |
| Reduced left ventricle ejection fraction less than 40% (n.%) | 0.82 (0.20–3.37) | 0.788 | 0.75 (0.18–3.08) | 0.688 | 0.99 (0.96–1.02) | 0.321 |
| Left atrial max volume, ml/m2 | 0.99 (0.98–1.01) | 0.921 | 1.00 (0.99–1.01) | 0.998 | 0.99 (0.98–1.02) | 0.852 |
| Estimated elevated LV filling pressures | 1.08 (0.49–2.34) | 0.852 | 0.79 (0.33–1.95) | 0.618 | 3.9 (0.76–7.81) | 0.102 |
| TR parameters | ||||||
| TR grade severe versus moderate (n.%) | 3.33 (2.07–5.35) | < 0.001 | 2.8 (1.60–4.80) | 0.001 | 7.11 (2.39–21.11) | < 0.001 |
| 2D-vena contracta average. Mm | 1.15 (1.09–1.20) | < 0.001 | 1.12 (1.07–1.19) | < 0.001 | 1.4 (1.2–1.7) | < 0.001 |
| 3D-vena contracta. cm2 | 1.52 (1.14–2.02) | < 0.001 | 1.37 (0.96–1.95) | 0.08 | 8.2 (1.9–20) | < 0.001 |
| 2DEROA (PISA) angle corrected, cm2 | 3.00 (1.84–4.91) | < 0.001 | 2.40 (1.30–4.30) | 0.003 | 2.00 (5.6–15.5) | 0.001 |
| Regurgitant volume angle-corrected, ml | 1.03 (1.02–1.04) | < 0.001 | 1.02 (1.01–1.04) | < 0.001 | 1.06 (1.03–1.09) | < 0.001 |
| Regurgitant fraction-angle corrected, n(%) | 9.43 (4.42–20.01) | < 0.001 | 12 (4.90–30.00) | < 0.001 | 7.5 (1.8–20) | 0.004 |
| Tricuspid valve remodeling | ||||||
| Tenting height, mm | 1.09 (1.04–1.17) | 0.002 | 1.11 (1.03–1.19) | 0.003 | 1.03 (0.88–1.21) | 0.691 |
| Tenting volume, ml | 1.12 (0.96–1.30) | 0.139 | 1.12 (0.96–1.31) | 0.154 | 1.11 (0.67–1.83) | 0.681 |
| Tricuspid annulus diameter, mm/m2 | 1.03 (0.99–1.06) | 0.091 | 1.03 (0.99–1.07) | 0.101 | 1.03 (0.96–1.11) | 0.343 |
| End diastolic tricuspid annulus area, cm2/m2 | 1.05 (0.97–1.12) | 0.211 | 1.13 (1.02–1.27) | 0.791 | 1.14 (1.02–1.27) | 0.025 |
| Mid systolic tricuspid annulus-area in, cm2/m2 | 1.00 (0.97–1.02) | 0.967 | 1.00 (0.98–1.012) | 0.982 | 1.01 (0.96–1.95) | 0.836 |
| RA dimensions | ||||||
| 3D-right atrial maximum volume, ml/m2 | 1.01 (1.00–1.02) | 0.005 | 1.01 (1.00–1.02) | 0.034 | 1.01 (1.00–1.02) | 0.016 |
| 3D-right atrial minimum volume, ml/m2 | 1.02 (1.01–1.03) | < 0.001 | 1.02 (1.01–1.04) | 0.001 | 1.03 (1.01–1.05) | 0.016 |
| RV-dimension and function | ||||||
| End-diastolic basal diameter, mm/m2 | 1.08 (1.04–1.12) | < 0.001 | 1.07 (1.02–1.11) | 0.004 | 1.15 (1.02–1.29) | 0.018 |
| End-diastolic volume, ml/m2 | 1.01 (1.00–1.01) | 0.001 | 1.01 (1.00–1.01) | 0.002 | 1.02 (1.00–1.04) | 0.046 |
| End-systolic volume, ml/m2 | 1.01 (1.00–1.02) | < 0.001 | 1.01 (1.00–1.02) | 0.001 | 1.016 (0.99–1.04) | 0.208 |
| Stroke volume, ml/m2 | 1.02 (1.00–1.04) | 0.016 | 1.01 (0.99–1.03) | 0.227 | 1.07 (1.02–1.14) | 0.013 |
| PASP, mmHg | 1.02 (1.01–1.03) | < 0.001 | 1.02 (1.01–1.03) | < 0.001 | 1.02 (0.99–1.04) | 0.225 |
| TAPSE, mm | 0.93 (0.88–0.98) | 0.004 | 0.92 (0.86–0.98) | 0.008 | 0.97 (0.87–1.08) | 0.598 |
| Free-wall longitudinal strain, % | 0.92 (0.88–0.96) | < 0.001 | 0.91 (0.87–0.96) | 0.001 | 0.97 (0.87–1.07) | 0.527 |
| 4-chamber strain, % | 0.94 (0.89–0.98) | 0.017 | 0.92 (0.87–0.98) | 0.011 | 1.00 (0.89–1.13) | 0.996 |
| Ejection fraction, % | 0.97 (0.95–0.99) | 0.012 | 0.96 (0.94–0.99) | 0.007 | 1.01 (0.95–1.07) | 0.782 |
| Right ventriculo-arterial coupling surrogates | ||||||
| TAPSE/PASP, mm/mmHg | 0.05 (0.01–0.22) | < 0.001 | 0.02 (0.01–0.16) | < 0.001 | 0.09 (0.01–1.25) | 0.073 |
| RVFWLS/SPAP%/mmHg | 0.05 (0.01–0.19) | < 0.001 | 0.01 (0.01–0.07) | < 0.001 | 0.28 (0.02–3.09) | 0.296 |
2D, two-dimensional; 3D, three-dimensional; A-STR, atrial secondary tricuspid regurgitation; PASP, pulmonary artery systolic pressure; RA, right atrium; RV, right ventricle; RVFWLS, Right ventricle free wall longitudinal strain; RVGLS, right ventricle global longitudinal strain; TA, tricuspid annulus; TR, tricuspid regurgitation; TAPSE, tricuspid annular plane systolic excursion; V-STR, ventricular secondary tricuspid regurgitation.