ArticleJournal of the American Heart Association2025
Association of Diuretic Dosage With Outcomes in Patients With Hemodynamically Significant Isolated Tricuspid Valve Regurgitation.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Effect of diuretic burden and model for end-stage liver disease-sodium score after isolated tricuspid valve surgery.Journal of thoracic disease · 2026Article
- Artificial Intelligence-Driven Detection, Characterization, and Risk Stratification in Patients with Severe Tricuspid Regurgitation.Arquivos brasileiros de cardiologia · 2026Observational
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTricuspid valve surgery is recommended for severe isolated tricuspid regurgitation (TR) if symptoms persist despite optimal medical therapy. The definition of optimal therapy for TR is unclear beyond managing underlying conditions. Diuretics are the primary treatment for volume retention in TR, but it is unknown whether a "safe diuretic dose" exists for conservative management. We sought to evaluate the association between diuretic dose and outcomes.
methodsAdult patients with ≥moderate-severe isolated TR were retrospectively identified from echocardiographic reports. Clinical and echocardiographic data were extracted from electronic medical records and manually reviewed. The primary end point was all-cause mortality. Loop diuretic doses were converted to furosemide equivalent and categorized into 4 groups: <40 mg, 40 to 79 mg, 80 to 159 mg, and ≥160 mg daily.
resultsOf 1302 patients (age 72±13 years, 60% female), 565 (43%) had moderate-severe TR and 737 (57%) had severe TR. Median follow-up was 8.7 (1.4, 14.0) years. Comorbidities increased with higher diuretic doses. A linear relationship between diuretic dose and mortality was observed in spline-curve analysis. Hazard ratios (and CIs) for mortality adjusted for age, sex, coronary disease, chronic kidney disease, mild pulmonary hypertension, and New York Heart Association III/IV symptoms were 1.21 (0.96-1.53) (
conclusionA daily loop diuretic dose ≥40 mg furosemide equivalent is associated with increased mortality and greater symptom severity in patients with TR.
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