Abstract 18422: Long-Term Changes in Tricuspid Regurgitation and Right Ventricular Function in Patients Undergoing Lung Transplantation: A 5-Year Study

Introduction: The presence and severity of tricuspid regurgitation (TR) has been associated with cardiovascular morbidity and mortality in a number of disease states. The impact of TR on future outcomes in patients selected for lung transplantation has not been adequately evaluated.

Methods: We retrospectively evaluated patients who underwent lung transplant at Cleveland Clinic between 2000 and 2022. Patients undergoing multi-organ transplant, CABG, surgery or valve repair were excluded. The presence of baseline TR and its severity was assessed on the closest echo antecedent to transplantation utilizing an IRB approved Echocardiography registry. We used survival analyses to assess our primary outcome of all-cause mortality. We also assessed distribution of TR severity over short and long-term follow up.

Results: We evaluated pre-transplant echocardiograms in 1490 individuals who had a mean age of 55 years; 60% being female. The proportion of 0, 1+, 2+, 3+ and 4+ TR was 56%, 25%,12%, 4% and 3% respectively. During a 5-year post-transplant follow-up period, the presence of severe TR pre-operatively was associated with an increased risk for all-cause mortality [aHR 2.1, 95% CI (1.09, 5.1); p = 0.029]. The distribution of TR severity did not appear to be significantly modified by the procedure at 6, 12, 24, 36, 48 and greater than 48-month follow up [OR 1.32, 95% CI (1.76), p = 0.062).

Conclusions: Pre-operative TR severity as measured by echocardiography was associated with an increase in all-cause mortality in patients undergoing lung transplant, but the distribution of TR severity did not significantly differ on long-term post-transplant follow up.