Prevalence, characteristics, and impact of frailty in patients with functional tricuspid regurgitation

Mike Saji, Tsutomu Yoshikawa, Morimasa Takayama, Yuki Izumi, Itaru Takamisawa, Tomonori Okamura, Hideyuki Shimizu, David Scott Lim, Azeem Latib, Mitsuaki Isobe, Keiichi Fukuda

Research output: Contribution to journalArticlepeer-review


Little is known as regards frailty in patients with functional tricuspid regurgitation (FTR). Thus, in this study, we aimed to investigate the prevalence, characteristics, and impact of frailty on patients with severe FTR. This prospective study included 110 consecutive patients with severe FTR who were assessed via transtho-racic echocardiography at an outpatient clinic. Patients were dichotomized using short physical performance bat-tery (SPPB). To better understand the whole picture of frailty in patients with FTR, other frailty scales were also assessed (frailty checklist, clinical frailty scale, gait speed, and Columbia frailty scale). The primary end-point was the combination of all-cause mortality and heart failure hospitalization. According to each definition of frailty, 28%-46% were identified to be frail. Those with SPPB score of < 9 were older, had greater New York Heart Association (NYHA) functional classification, and had lower albumin level and estimated glomerular filtration rate compared with those with SPPB score of ≥9. They also have smaller tricuspid valve coaptation depth and worse right ventricular fractional area change (RV-FAC) than those with SPPB score of ≥9 despite having similar TR severity. The primary endpoint at 1 year was noted in 31% of patients. The SPPB score has excellent discriminatory performance for predicting the primary endpoint (area under the curve 0.82, 95% confidence interval [CI] 0.76-0.91) in receiver operating characteristic analysis and was independently associated with the primary endpoint after adjustment in multivariate analysis (adjusted haz-ard ratio 0.81, 95% CI, 0.73-0.90; P < 0.001). Frailty has been widely prevalent in the elderly patient population with FTR; in fact, it has been deter-mined to be strong parameter for poor outcomes.

Original languageEnglish
Pages (from-to)1280-1286
Number of pages7
JournalInternational Heart Journal
Issue number6
Publication statusPublished - 2021


  • All-cause mortality

ASJC Scopus subject areas

  • General Medicine


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