Data Sheet 1_Predictors of significant tricuspid regurgitation in atrial fibrillation: a meta-analysis.docx

AimsSignificant 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 evaluate potential predictors of significant TR in AF patients using open databases.
MethodsPubMed, EMBASE, the Cochrane Library, and Web of Science were searched for relevant studies from inception to September 2023. Using STATA 14.0 statistical software, hazard ratios (HRs) were calculated for data synthesis. The potential predictors included clinical characteristics, echocardiography parameters, and prior comorbidities. Evidence certainty was evaluated based on the GRADE system.
ResultsIn total, 12 studies involving almost 16,000 patients were included in this review. Female sex (HR = 2.14; 95% CI: 1.84–2.49; I2 = 0.0%; p = 0.430), persistent atrial fibrillation (HR = 2.99; 95% CI: 2.47–3.61; I2 = 0.0%; p = 0.896), left ventricular ejection fraction [standard mean difference (SMD) = −0.16; 95% CI:−0.30 to −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 (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 (HR = 1.33; 95% CI: 1.02–1.74; I2 = 0.0%; p = 0.882), right ventricle fractional area change (SMD = 0.18; 95% CI: 0.01–0.36; I2 = 0.0%; p = 0.440), systolic pulmonary arterial pressure (SMD = 0.97; 95% CI: 0.76–1.19; I2 = 41.5%; p = 0.181), and proper ventricular systolic pressure (SMD = 1.07; 95% CI: 0.54–1.59; I2 = 92.4%; p < 0.000) may negatively influence significant TR.
ConclusionsThis 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.

研究目的 心房颤动（atrial fibrillation, AF）患者合并重度三尖瓣反流（tricuspid regurgitation, TR）已成为全球性公共健康议题，该病可引发进行性右心室扩大与心力衰竭，进而升高患者的发病率与死亡率。本研究旨在利用公开数据库，探究心房颤动患者发生重度三尖瓣反流的潜在预测因素。
方法 本研究检索了PubMed、EMBASE、Cochrane图书馆及Web of Science自建库至2023年9月的相关研究。采用STATA 14.0统计软件计算风险比（hazard ratios, HR）以进行数据合并分析。潜在预测因素涵盖临床特征、超声心动图参数及既往合并症。证据质量采用GRADE系统进行评估。
结果 本荟萃分析共纳入12项研究，涉及近16000名患者。分析结果显示，女性性别（HR=2.14；95%CI：1.84~2.49；I²=0.0%；p=0.430）、持续性心房颤动（HR=2.99；95%CI：2.47~3.61；I²=0.0%；p=0.896）、左心室射血分数[标准化均数差（standard mean difference, SMD）=-0.16；95%CI：-0.30~-0.03；I²=69.8%；p<0.000]、年龄（HR=1.07；95%CI：1.04~1.09；I²=72.3%；p=0.013）、心力衰竭（HR=1.86；95%CI：1.45~2.39；I²=9.0%；p=0.348）、年龄≥65岁（HR=2.30；95%CI：1.63~3.25；I²=55.1%；p=0.108）、慢性肺部疾病（HR=1.33；95%CI：1.02~1.74；I²=0.0%；p=0.882）、右心室分数面积变化（SMD=0.18；95%CI：0.01~0.36；I²=0.0%；p=0.440）、收缩期肺动脉压（SMD=0.97；95%CI：0.76~1.19；I²=41.5%；p=0.181）及右心室收缩压（SMD=1.07；95%CI：0.54~1.59；I²=92.4%；p<0.000）均可能升高重度三尖瓣反流的发生风险。
结论 本荟萃分析明确了多项临床特征、超声心动图参数及既往合并症与重度三尖瓣反流发生风险升高存在潜在关联。但由于证据质量等级较低，本研究结果仅能为临床从业者与科研人员提供一定参考。临床实践中需谨慎解读结果，且仍需进一步研究加以验证。