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Title: | Right Ventricular Reverse Remodeling After Tricuspid Valve Surgery for Significant Tricuspid Regurgitation | Authors: | Galloo, Xavier Meucci, Maria Chiara STASSEN, Jan Dietz, Marlieke F. Prihadi, Edgard A. van der Bijl, Pieter Marsan, Nina Ajmone Braun, Jerry Bax, Jeroen J. Delgado, Victoria |
Issue Date: | 2023 | Publisher: | ELSEVIER SCIENCE INC | Source: | STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM, 7 (1) (Art N° 100101) | Abstract: | Background: Changes in right ventricular (RV) dimensions and function after tricuspid valve (TV) surgery and their association with long-term outcomes remain largely unexplored. The current study evaluated RV reverse remodeling, based on changes in RV dimensions and function, after TV surgery for significant (moderate or severe) tricuspid regurgitation (TR) and their association with outcome.Methods: A total of 121 patients (mean age 63 +/- 12 years, 47% males) with significant TR treated with TV surgery were included in this analysis. The population was stratified by tertiles of percentage reduction of RV end-systolic area (RVESA) and absolute change of RV fractional area change (RVFAC). Five-year mortality rates were compared across the tertiles of RV remodeling and independent associates of mortality were investigated.Results: Tertile 3 consisted of patients presenting with a reduction in RVESA >= 17.2% and an improvement in RVFAC >= 2.3% after TV surgery. Cumulative survival rates were significantly better in patients within tertile 3 of RVESA reduction: 90% vs. 49% for tertile 1 and 69% for tertile 2 (log-rank p = 0.002) and within tertile 3 of RVFAC improvement: 87% vs. 57% for tertile 1 and 65% for tertile 2 (log-rank p = 0.02). Tertiles 3 of RVESA reduction and RVFAC improvement were both independently associated with better survival after TV surgery compared to tertiles 1 (hazard ratio: 0.221 [95% CI: 0.074-0.658] and 0.327 [95% CI: 0.118-0.907], respectively).Conclusions: The extent of RV reverse remodeling, based on reduction in RVESA and improvement in RVFAC, was associated with better survival at 5-year follow-up of TV surgery for significant TR. | Notes: | Delgado, V (corresponding author), Leiden Univ, Dept Cardiol, Med Ctr, Albinusdreef 2, NL-2330 RC Leiden, Netherlands. v.delgado@lumc.nl |
Keywords: | Prognosis;Right ventricular remodeling;Tricuspid regurgitation;Tricuspid valve surgery | Document URI: | http://hdl.handle.net/1942/40443 | ISSN: | 2474-8706 | e-ISSN: | 2474-8714 | DOI: | 10.1016/j.shj.2022.100101 | ISI #: | 000996308200001 | Rights: | 2022 The Author(s). Published by Elsevier Inc. on behalf of Cardiovascular Research Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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Right Ventricular Reverse Remodeling After Tricuspid Valve Surgery for Significant Tricuspid Regurgitation.pdf | Published version | 1.22 MB | Adobe PDF | View/Open |
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