Tricuspid regurgitation severity may be underestimated in transthyretin amyloid cardiomyopathy because conventional echocardiographic criteria were derived from nonamyloid populations. The restrictive, low-flow hemodynamics characteristic of the disease may require disease-specific thresholds for more accurate prognostic assessment. This study derived and validated prognostic quantitative echocardiographic thresholds for tricuspid regurgitation and compared them with current guideline and Tricuspid Valve Academic Research Consortium grading schemes.

Among 1,124 patients with newly diagnosed transthyretin amyloid cardiomyopathy, 745 were included in the derivation cohort and 379 in the validation cohort. The median age was 80 years, and 260 patients (23.1%) were female. During a median follow-up of 25.2 months, 324 patients (28.8%) died and 251 (22.3%) experienced heart failure…