Severe TR significantly worsens outcomes in patients with HF. A meta-analysis published in Heart and Lung pooled data from 10 studies including 456,353 patients with HF to assess the long-term impact of moderate-to-severe TR.

The analysis revealed that severe TR was associated with higher odds of 1-year mortality (OR 1.25; 95% confidence interval [CI] 1.02–1.52; p = 0.03) and 2-year mortality (OR 1.63; 95% CI 1.28–2.09; p < 0.01). Patients with severe TR also had increased risks of HF-related hospitalizations (OR 1.39; 95% CI 1.14–1.71; p < 0.01) and composite adverse outcomes (OR 1.44; 95% CI 1.10–1.88; p < 0.01). However, there was no significant association with cardiovascular-specific deaths (OR 1.35; 95% CI 0.82–2.24; p = 0.24).

Sensitivity analysis demonstrated that excluding one large study (Adamo et al., 2024) slightly altered the pooled effect estimate, suggesting moderate influence on the overall outcome.
These findings underscore the prognostic importance of TR in patients with HF. Early identification and timely management of TR may reduce mortality and hospitalization rates, improving long-term outcomes in this high-risk population.