Right Ventricular Longitudinal Strain Predicts Survival in Patients With Functional Tricuspid Regurgitation.

Autor: Bannehr M; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany. Electronic address: marwin.bannehr@immanuelalbertinen.de., Kahn U; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany., Liebchen J; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany., Okamoto M; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany., Hähnel V; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany., Georgi C; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany., Dworok V; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany., Edlinger C; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany; Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria., Lichtenauer M; Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria., Kücken T; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany., Kropf S; Institute for Biometrics and Medical Informatics, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany., Haase-Fielitz A; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany; Institute of Social Medicine and Health Economics, Otto von Guericke University Magdeburg, Magdeburg, Germany., Butter C; Department of Cardiology, Heart Center Brandenburg Bernau and Brandenburg Medical School, Bernau bei Berlin, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany.
Jazyk: angličtina
Zdroj: The Canadian journal of cardiology [Can J Cardiol] 2021 Jul; Vol. 37 (7), pp. 1086-1093. Date of Electronic Publication: 2021 Jan 13.
DOI: 10.1016/j.cjca.2021.01.006
Abstrakt: Background: Functional tricuspid regurgitation (TR) is a frequent finding in echocardiography. Despite general consent that right ventricular (RV) dysfunction impacts outcome of patients with TR, it is still unknown which echocardiographic parameters most accurately reflect prognosis. In this study we aimed to evaluate the prevalence of RV dysfunction and its prognostic value in patients with TR.
Methods: Data from 1089 consecutive patients were analysed. Tricuspid annular plane systolic excursion (TAPSE), fractional area change, and right ventricular free wall longitudinal strain (RV strain) were used to define RV dysfunction. Patients were followed for 2-year all-cause mortality. For prediction of survival, reclassification and C statistics of RV functional parameters using TR grade as reference model were performed.
Results: Among the patients studied, 13.9% showed no TR, 61.2% had mild TR, 19.6% had moderate TR, and 5.3% had severe TR. The TR grade was associated with increased mortality (log rank, P < 0.001). Impaired RV strain and TAPSE were independent predictors for mortality (RV: hazard ratio [HR], 1.130; 95% confidence interval [CI], 1.099-1.160; P < 0.001; TAPSE: HR, 1.131; 95% CI, 1.085-1.175; P < 0.001). Both RV strain and TAPSE improved the reference model for survival prediction (RV: integrated discrimination improvement [IDI], 0.184; 95% CI, 0.146-0.221; P < 0.001; TAPSE: IDI, 0.057; 95% CI, 0.037-0.077; P < 0.001).
Conclusions: Echocardiographic evaluation of RV function appears to useful for patients with TR. Assessment of RV strain provides additional value for prediction of 2-year mortality.
(Copyright © 2021 [Author/Employing Institution]. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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