The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant.

Autor: Veen KM; Department of Cardiothoracic Surgery, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Papageorgiou G; Department of Biostatistics, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Zijderhand CF; Department of Cardiothoracic Surgery, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Mokhles MM; Department of Cardiothoracic Surgery, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Brugts JJ; Department of Cardiology, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Manintveld OC; Department of Cardiology, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Constantinescu AA; Department of Cardiology, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Bekkers JA; Department of Cardiothoracic Surgery, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Takkenberg JJM; Department of Cardiothoracic Surgery, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Bogers AJJC; Department of Cardiothoracic Surgery, Erasmus MC, 3000 CA, Rotterdam, The Netherlands., Caliskan K; Department of Cardiology, Erasmus MC, 3000 CA, Rotterdam, The Netherlands. k.caliskan@erasmusmc.nl.
Jazyk: angličtina
Zdroj: Frontiers of medicine [Front Med] 2023 Jun; Vol. 17 (3), pp. 527-533. Date of Electronic Publication: 2023 Mar 31.
DOI: 10.1007/s11684-022-0967-5
Abstrakt: In this study, we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation (TR), taking into account its dynamic nature, after biatrial orthotopic heart transplant (OHT). All consecutive adult patients undergoing biatrial OHT (1984-2017) with an available follow-up echocardiogram were included. Mixed-models were used to model the evolution of TR. The mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with mortality. In total, 572 patients were included (median age: 50 years, males: 74.9%). Approximately 32% of patients had moderate-to-severe TR immediately after surgery. However, this declined to 11% on 5 years and 9% on 10 years after surgery, adjusted for survival bias. Pre-implant mechanical support was associated with less TR during follow-up, whereas concurrent LV dysfunction was significantly associated with more TR during follow-up. Survival at 1, 5, 10, 20 years was 97% ± 1%, 88% ± 1%, 66% ± 2% and 23% ± 2%, respectively. The presence of moderate-to-severe TR during follow-up was associated with higher mortality (HR: 1.07, 95% CI (1.02-1.12), p = 0.006). The course of TR was positively correlated with the course of creatinine (R = 0.45). TR during follow-up is significantly associated with higher mortality and worse renal function. Nevertheless, probability of TR is the highest immediately after OHT and decreases thereafter. Therefore, it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.
(© 2023. Higher Education Press.)
Databáze: MEDLINE
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