6533b822fe1ef96bd127cc01

RESEARCH PRODUCT

Value of Echocardiographic Right Ventricular and Pulmonary Pressure Assessment in Predicting Transcatheter Tricuspid Repair Outcome

Hannes AlessandriniNicolas BruggerNicole KaramChristian FrerkerKarl Philipp RommelSimon DeseiveKim A. ConnellyKarl-heinz KuckAzeem LatibTobias RufHorst SievertStephan WindeckerFlorian DeuschlGeorg NickenigMara GavazzoniMarcel WeberLaura VaskelyteHasan AhmadMaurizio TaramassoJoachim SchoferLuigi BiascoUlrich SchäferErmela YzeirajPhilipp LurzEdwin C. HoNeil FamMichael NabauerGilbert H.l. TangStephan Von BardelebenChristian BeslerMathias OrbanMichael MehrFrancesco MaisanoAntonio MangieriGiovanni PedrazziniSteffen MassbergJörg HausleiterDavide SchiaviPaolo DentiDaniel BraunAlberto Pozzoli

subject

MaleCardiac Catheterizationmedicine.medical_specialtyTime FactorsRegurgitation (circulation)Pulmonary Artery030204 cardiovascular system & hematologySeverity of Illness Index03 medical and health sciences0302 clinical medicinePrimary outcomePredictive Value of TestsInternal medicinemedicine.arteryVentricular PressureHumansMedicineArterial PressureProspective StudiesRegistries030212 general & internal medicineAgedAged 80 and overHeart FailureHospital readmissionTricuspid valvebusiness.industryRecovery of FunctionMiddle Agedmedicine.diseasePulmonary hypertensionTricuspid Valve Insufficiency3. Good healthPulmonary pressureEuropeTreatment Outcomemedicine.anatomical_structureEchocardiographyHeart failureNorth AmericaPulmonary arteryDisease ProgressionVentricular Function RightCardiologyFemaleCardiology and Cardiovascular Medicinebusiness

description

The aim of this study was to assess the value of echocardiographic right ventricular (RV) and systolic pulmonary artery pressure (sPAP) assessment in predicting transcatheter tricuspid edge-to-edge valve repair (TTVR) outcome.RV dysfunction and pulmonary hypertension are associated with poor prognosis and are systematically sought during tricuspid regurgitation evaluation. The value of echocardiographic assessment in predicting TTVR outcome is unknown.Data were taken from the TriValve (Transcatheter Tricuspid Valve Therapies) registry, which includes patients undergoing TTVR at 14 European and North American centers. The primary outcome was 1-year survival free from hospitalization for heart failure, and secondary outcomes were 1-year survival and absence of hospital admission for heart failure at 1 year.Overall, 249 patients underwent TTVR between June 2015 and 2018 (mean tricuspid annular plane systolic excursion [TAPSE] 15.8 ± 15.3 mm, mean sPAP 43.6 ± 16.0 mm Hg). Tricuspid regurgitation grade ≥3+ was found in 96.8% of patients at baseline and 29.4% at final follow-up; 95.6% were in New York Heart Association functional class III or IV initially, compared with 34.3% at follow-up (p  0.05). Final New York Heart Association functional class did not differ among TAPSE and sPAP quartiles, even when both low TAPSE and high sPAP were present. Rates of 1-year survival and survival free from hospitalization for heart failure were 83.9% and 78.7%, respectively, without significant differences according to baseline echocardiographic RV characteristics (TAPSE, fractional area change, and end-diastolic area) and sPAP (p0.05 for all).TTVR provides clinical improvement, with 1-year survival free from hospital readmission75% in patients with severe tricuspid regurgitation. Conventional echocardiographic parameters used to assess RV function and sPAP did not predict clinical outcome after TTVR.

yearjournalcountryeditionlanguage
2020-05-01JACC: Cardiovascular Interventions
https://doi.org/10.1016/j.jcin.2020.02.028