Tricuspid regurgitation (TR) is common in patients with orthotopic heart transplantation (HTX). Nevertheless, the clinical impact and the long-term outcome of TR remains controversial. In this study we aim to elucidate the clinical impact and long-term outcome of TR, taking into account its dynamic nature.
All consecutive adults patients undergoing biatrial HTX in our tertiary center with a follow-up echocardiogram were included in this study. Mixed-models were used to model the evolution of TR over time. Thereafter, the mixed-model was inserted into a Cox model, under the joint-model framework, in order to address the association of the dynamic TR with mortality.
This meta-analysis provides the first reliable pain prevalence estimate in a large international sample of adults with CP. The high prevalence of pain, 70%, suggests that adults with CP should be routinely screened for pain and treated accordingly. The range of measurement instruments used by the included studies emphasizes using common outcome measures specific to pain internationally. Moderate-to-severe TR after HTX is common and the highest immediately after HTX and decreases steadily over the years. TR during follow-up is significantly associated with higher morbidity and mortality. Therefore, further research is urgently needed for the prevention, appropriate medical treatment, and timely surgical intervention of TR post-HTX.