Prognostic Implications of Right Ventricular Remodeling and Function in Patients With Significant Secondary Tricuspid Regurgitation
| Autor: | Edgard A. Prihadi, Bart Mertens, Nina Ajmone Marsan, Jeroen J. Bax, Olton S. van Genderen, Erhan Gursoy, Marlieke F. Dietz, Laurien Goedemans, Victoria Delgado, Pieter van der Bijl |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Heart Ventricles Regurgitation (circulation) Tricuspid Valve Insufficiency Physiology (medical) Internal medicine right medicine Humans Ventricular Function In patient Ventricular remodeling Aged Ventricular Remodeling business.industry ventricular dysfunction Middle Aged medicine.disease Survival Analysis Echocardiography tricuspid valve insufficiency Cardiology Disease Progression Female prognosis Cardiology and Cardiovascular Medicine business dilatation Dilatation Pathologic Follow-Up Studies |
| Zdroj: | Circulation Circulation, 140(10), 836-845 |
| DOI: | 10.1161/circulationaha.119.039630 |
| Popis: | Background: In patients with significant (moderate and severe) tricuspid regurgitation (TR), the decision to intervene is influenced by right ventricular (RV) size and function. RV remodeling in significant secondary TR has been underexplored. The aim of this study was to characterize RV remodeling in patients with significant secondary TR and to investigate its prognostic implications. Methods: RV remodeling was characterized by transthoracic echocardiography in 1292 patients with significant secondary TR (median age 71 [62–78]; 50% male). Four patterns of RV remodeling were defined according to the presence of RV dilation (tricuspid annulus≥40 mm) and RV systolic dysfunction (tricuspid annulus systolic excursion plane Results: A total of 183 (14%) patients showed pattern 1 RV remodeling; 256 (20%) showed pattern 2; 304 (24%) presented with pattern 3; and 549 (43%) had pattern 4 RV remodeling. Patients with pattern 4 RV remodeling were more frequently male; more often had coronary artery disease, worse renal function, and impaired left ventricular ejection fraction; and were more often symptomatic. Only 98 (8%) patients underwent tricuspid valve annuloplasty during follow-up. During a median follow-up of 34 (interquartile range, 0–60) months, 510 (40%) patients died. The 5-year survival rate was significantly worse in patients presenting with patterns 3 and 4 RV remodeling in comparison with pattern 1 (52% and 49% versus 70%; P =0.002 and P Conclusions: In patients with significant secondary TR, patients with RV systolic dysfunction have worse clinical outcome regardless of the presence of RV dilation. |
| Databáze: | OpenAIRE |
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