Development and validation of an echocardiographic algorithm to predict long-term mitral and tricuspid regurgitation progression.

Autor:	Strom JB; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Zhao Y; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Shen C; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Wasfy JH; Harvard Medical School, Boston, MA, USA.; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA., Xu J; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Yucel E; Harvard Medical School, Boston, MA, USA.; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA., Tanguturi V; Harvard Medical School, Boston, MA, USA.; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA., Hyland PM; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Harvard Medical School, Boston, MA, USA., Markson LJ; Harvard Medical School, Boston, MA, USA.; Information Systems, Beth Israel Deaconess Medical Center, Boston, MA, USA., Kazi DS; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Cui J; Harvard Medical School, Boston, MA, USA.; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA., Hung J; Harvard Medical School, Boston, MA, USA.; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA., Yeh RW; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Manning WJ; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA 02215, USA.; Harvard Medical School, Boston, MA, USA.; Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2022 Nov 17; Vol. 23 (12), pp. 1606-1616.
DOI:	10.1093/ehjci/jeab254
Abstrakt:	Aims: Prediction of mitral (MR) and tricuspid (TR) regurgitation progression on transthoracic echocardiography (TTE) is needed to personalize valvular surveillance intervals and prognostication. Methods and Results: Structured TTE report data at Beth Israel Deaconess Medical Center, 26 January 2000-31 December 2017, were used to determine time to progression (≥1+ increase in severity). TTE predictors of progression were used to create a progression score, externally validated at Massachusetts General Hospital, 1 January 2002-31 December 2019. In the derivation sample (MR, N = 34 933; TR, N = 27 526), only 5379 (15.4%) individuals with MR and 3630 (13.2%) with TR had progression during a median interquartile range) 9.0 (4.1-13.4) years of follow-up. Despite wide inter-individual variability in progression rates, a score based solely on demographics and TTE variables identified individuals with a five- to six-fold higher rate of MR/TR progression over 10 years (high- vs. low-score tertile, rate of progression; MR 20.1% vs. 3.3%; TR 21.2% vs. 4.4%). Compared to those in the lowest score tertile, those in the highest tertile of progression had a four-fold increased risk of mortality. On external validation, the score demonstrated similar performance to other algorithms commonly in use. Conclusion: Four-fifths of individuals had no progression of MR or TR over two decades. Despite wide interindividual variability in progression rates, a score, based solely on TTE parameters, identified individuals with a five- to six-fold higher rate of MR/TR progression. Compared to the lowest tertile, individuals in the highest score tertile had a four-fold increased risk of mortality. Prediction of long-term MR/TR progression is not only feasible but prognostically important. Competing Interests: Conflict of interest: Dr Strom additionally reports grant funding from Edwards Lifesciences, Anumana, Heartsciences, and Ultromics, consulting for Bracco Diagnostics, and speaker fees from Northwest Imaging Forums, unrelated to the submitted work. Dr Yeh reports additional grant support from Abbott Vascular, Astra Zeneca, BD Bard, Boston Scientific Cook, Philips Medical and Medtronic, and consulting fees from Abbott, AstraZeneca, Boston Scientific, Edwards Life Sciences, Medtronic, Shockwave Medical and Zoll outside the submitted work. Dr Wasfy reports grant support from the American Heart Association, National Institutes of Health, consulting fees from Pfizer and Biotronik, and honoraria from the New England Comparative Effectiveness Public Affairs Council. The remaining authors have nothing to disclose. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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