Oncologic diseases and impact on prognosis in patients with severe isolated tricuspid regurgitation.

Varius Dannenberg (Wien)1, K. Mascherbauer (Wien)1, F. Zschocke (Wien)1, K. Halavina (Wien)2, G. Heitzinger (Wien)1, M. Koschutnik (Wien)1, C. Doná (Wien)1, C. Nitsche (Wien)1, A. Kammerlander (Wien)1, G. Spinka (Wien)1, M.-P. Winter (Wien)1, P. E. Bartko (Wien)1, C. Hengstenberg (Wien)1, J. Bergler-Klein (Wien)1, G. Goliasch (Wien)1, M. Schneider-Reigbert (Berlin)3

1Universitätsklinikum AKH Wien Medizinische - Universität Wien Innere Medizin II, Klinische Abteilung für Kardiologie Wien, Österreich; 2Medizinische Universität Wien/ AKH Wien Klinische Abteilung für Kardiologie Wien, Österreich; 3Charité - Universitätsmedizin Berlin CC11: Med. Klinik m.S. Kardiologie Berlin, Deutschland


Background: Severe tricuspid regurgitation (TR) is associated with increased rates of hospitalization and death. Isolated TR, defined as TR without left heart disease, is a relatively uncommon disease with often unclear origin. TR may occur in oncologic patients as a consequence of chemotherapy or radiotherapy, oxidative stress and toxic radicals, or due to hormone circulation in neuroendocrine tumors. Nevertheless, the prognostic impact of TR in oncologic patients is scarcely studied.

Aims: To investigate the survival rates of severe isolated TR in patients with different cancer types and status.

Methods: We included all patients diagnosed with severe TR at the Medical University of Vienna between 2003 and 2016 with normal left ventricular function and no other valvular lesions. Outcome analysis was performed according to cancer type and cancer status at last follow-up.

Results: A total of 973 patients were included, 182 (19%) patients had cancer, 52 active and 130 history of cancer at the time of TR diagnosis. Oncologic patients were divided into subgroups of gastrointestinal, skin, glands, gynecological, breast, urogenital, lung, and other cancer. Ten-year mortality of patients with cancer were higher than mortality of patients without cancer (p<0.001). Multivariate analysis adjusting for age did not reveal significantly higher mortality in patients with a history of cancer compared to patients without cancer (p=0.59).

Conclusions: Mortality in patients with severe isolated TR is high and increased by active cancer but not by a history of cancer. TR treatment in cancer patients is complex and should be discussed in interdisciplinary cardio-oncologic teams.

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