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SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.
Sec. Heart Valve Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1428964

Predictors of Significant Tricuspid Regurgitation in Atrial Fibrillation: a meta-analysis

Provisionally accepted
Xiuxiu Zhang Xiuxiu Zhang Na Zhang Na Zhang Jia Fu Jia Fu Dapeng Yu Dapeng Yu *
  • Other, Liaocheng, China

The final, formatted version of the article will be published soon.

    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 evaluated potential predictors of significant TR in AF patients using open databases. Methods: PubMed, EMBASE, the Cochrane Library, and Web of Science were retrieved for relevant studies from inception to September 2023. Based on STATA 14.0 statistical software, hazard ratio was used for data synthesis. The potential predictors included clinical characteristics, echocardiography parameters, and prior comorbidities. Evidence certainty was evaluated based on GRADE system. Results: 12 studies involving almost 16000 patients were included in this review. Female (HR=2.14; 95% CI:1.84,2.49; I2=0.0%; p=0.430), persistent atrial fibrillation (PAF) (HR=2.99; 95% CI:2.47,3.61; I2=0.0%; p=0.896), left ventricular ejection fraction (LVEF) (SMD=-0.16; 95% CI:-0.30, -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 (HF) (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 (CLD) (HR=1.33; 95% CI:1.02,1.74; I2=0.0%; p=0.882), right ventricle fractional area change (RV FAC)(SMD=0.18; 95% CI:0.01, 0.36; I2=0.0%; p=0.440), systolic pulmonary arterial pressure (SPAP) (SMD=0.97; 95% CI:0.76, 1.19; I2=41.5%; p=0.181) and proper ventricular systolic pressure (RVSP) (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.

    Keywords: Significant Tricuspid Regurgitation, Atrial Fibrillation, Echocardiography parameters, predictors, Meta-analysis

    Received: 07 May 2024; Accepted: 24 Jan 2025.

    Copyright: © 2025 Zhang, Zhang, Fu and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Dapeng Yu, Other, Liaocheng, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.