Quantitative assessment of effective regurgitant orifice: impact on risk stratification, and cut-off for severe and torrential tricuspid regurgitation grade
| Autor: | Ido Nachmany, Aviram Hochstadt, Chen Sherez, Gad Keren, Simon Biner, Galit Aviram, Yan Topilsky, Nir Flint, Guy Topaz, Yogev Peri, Ben Sadeh, Meirav Ingbir |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Tricuspid Valve Insufficiency Internal medicine medicine Quantitative assessment Humans Radiology Nuclear Medicine and imaging In patient 030212 general & internal medicine Aged Proportional Hazards Models Aged 80 and over Ejection fraction business.industry Hazard ratio General Medicine Middle Aged ROC Curve Risk stratification Cardiology Cut-off Cardiology and Cardiovascular Medicine business Body orifice |
| Zdroj: | European Heart Journal - Cardiovascular Imaging. 21:768-776 |
| ISSN: | 2047-2412 2047-2404 |
| DOI: | 10.1093/ehjci/jez267 |
| Popis: | Aims Asses the added value of quantitative evaluation of tricuspid regurgitation (TR), the proper cut-off value for severe TR and ‘torrential TR’ based on outcome data. The added value of quantitative evaluation of TR, and the cut-off values associated with increased mortality are unknown. Methods and results In patients with all-cause TR assessed both qualitatively and quantitatively by proximal iso-velocity surface area method, long-term and 1-year outcome analysis was conducted. Thresholds for excess mortality were assessed using spline curves, receiver-operating characteristic curves, and minimum P-value analysis. The study involved 676 patients with all-cause TR (age 73.9 ± 14 years, male 45%, ejection fraction 52.9 ± 14%). Effective regurgitant orifice (ERO) was strongly associated with decreased survival in unadjusted [hazard ratio (HR) 2.38 (1.79–3.01), P Conclusion TR can be severe and even ‘torrential’ and is associated with excess mortality. Quantitative assessment of TR by ERO measurement is a powerful independent predictor of outcome, superior to standard qualitative assessment. The optimal cut-off above which mortality is increased is 0.35 cm2, similar albeit slightly lower than suggested in recent guidelines. Torrential TR >0.7 cm2 is associated with poorer survival compared to patients with severe TR (ERO > 0.4 cm2 and |
| Databáze: | OpenAIRE |
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