Health Status After Transcatheter Tricuspid Valve Repair in Patients With Functional Tricuspid Regurgitation

Kitamura, Mitsunobu; Kresoja, Karl‐Patrik; Balata, Mahmoud; Besler, Christian; Rommel, Karl‐Philipp; Unterhuber, Matthias; Lurz, Julia; Rosch, Sebastian; Gunold, Hilka; Noack, Thilo; Thiele, Holger; Lurz, Philipp

doi:10.1016/j.jcin.2021.09.021

Cited by 13 publications

(2 citation statements)

References 33 publications

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“…HRQL assessments include single ratings [ 3 ] and multidimensional profiles that span physical health, cognitive-emotional well-being, and social engagement or support [ 4 , 5 ]. There is an extensive range of HRQL instruments with demonstrated validity and reliability, and that serve as prognostic indicators for clinical outcomes [ 6 , 7 ]. A separate lineage of research quantifies HRQL using a standardized utility value for a given medical condition, which is adjusted according to a specified time period of living with that condition (e.g.…”

Section: Introductionmentioning

confidence: 99%

A process-based approach to health-related quality of life as a “way of living”

Nolan

Sharpe

2023

Qual Life Res

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Introduction There is an historical initiative to establish common theoretical ground to support a framework for assessing health-related quality of life (HRQL). Our aim was to add to this effort with an analysis of theoretical/philosophical themes embedded in HRQL questionnaires and patient reports. Methods and Results We reviewed recent developments in HRQL assessment. This included analyzing a representative sample of psychometric measures of HRQL to schematically summarize core theoretical/philosophical themes that are embedded in questionnaire items. This analysis indicated a state-based framework for HRQL that was characterized by themes of hedonic and eudaimonic well-being, and desire-satisfaction. In contrast, a review of patient reports of HRQL indicated a process-based framework where goal-directed activities aimed to secure aspirational life goals while striving to accept the reality of declining health. Given this difference in HRQL themes we used a meta-philosophical approach, based on Hadot’s idea of philosophy as a way of living, to identify a process-based theoretical framework for HRQL assessment that addressed patient-reported themes. The Stoic modification of eudaimonic well-being was examined where HRQL and well-being are viewed as a process (vs. state) aimed at transforming the experience of loss or grief in response to adversity through goal-directed activities/exercises (euroia biou, good flow in life). We then introduced a complementary research agenda for HRQL assessment that incorporates self-reported, goal-directed activities that are initiated or maintained to promote HRQL. Conclusion A process-based approach to HRQL assessment may increase the spectrum of clinically relevant features that currently comprise operational measures of this patient-reported appraisal.

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Section: Introductionmentioning

confidence: 99%

A process-based approach to health-related quality of life as a “way of living”

Nolan

Sharpe

2023

Qual Life Res

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“…In einer "Propensity-matched"-Fallkontrollstudie zeigte sich darüber hinaus eine reduzierte 1-Jahres-Letalität [16]. Zusätzlich konnte gezeigt werden, dass einhergehend mit der TI-Reduktion mittels "Edge-to-Edge"-Therapie sowohl Symptome als auch die Lebensqualität verbessert werden konnten [14,17].…”

Section: Verfahren Zur Kathetergestützten Therapie Der Trikuspidalklappeunclassified

Kathetergestützte Therapien der Trikuspidalklappe – Aktuelles jenseits der Leitlinien

Schöber

Lurz

2022

Aktuelle Kardiologie

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ZusammenfassungInnerhalb von weniger als einer Dekade ist die Trikuspidalklappeninsuffizienz (TI) von einer „vergessenen“ Erkrankung zu einem wichtigen wissenschaftlichen und klinischen Eckpunkt der kardiovaskulären Medizin geworden. Aus der Notwendigkeit heraus, Therapieoptionen auch für Hochrisikopatienten anbieten zu können, wurden vielversprechende kathetergestützte Verfahren entwickelt. Diese haben zum Teil bereits im klinischen Alltag, jedoch in Abwesenheit abgeschlossener prospektiver Studien noch nicht in Gänze in die Leitlinien Einzug gehalten. Die Entscheidungen bezüglich der Patientenauswahl und des Therapieverfahrens müssen daher zum jetzigen Zeitpunkt auf Basis von retrospektiven Studien und pathophysiologischen Überlegungen getroffen werden. Hierbei spielt die interdisziplinäre Beurteilung dieser Aspekte im Heart Team eine wichtige Rolle, mit dem Ziel, immer mehr Patienten einem optimalen Therapiekonzept zuführen zu können.

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Role of preexisting right ventricular remodeling in symptoms and prognosis after transcatheter tricuspid valve repair

Ehrenfels,

Fretter,

von Stein

et al. 2024

Clin Res Cardiol

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Background Severe tricuspid regurgitation (TR) is associated with chronic volume overload and right ventricular remodeling (RVR). Transcatheter tricuspid valve repair (TTVr) reduces TR and can improve quality of life (QoL), but the role of preprocedural RVR on TTVr outcomes remains unclear. Aims To investigate the role of RVR on outcomes after TTVr for severe TR. Methods Consecutive patients undergoing TTVr (61% edge-to-edge vs. 39% direct annuloplasty) for severe TR were retrospectively compared by preexisting RVR which was defined as dilation of RV mid-level diameter (> 35 mm) according to guidelines. QoL was evaluated using NYHA class, Minnesota Living with Heart Failure Questionnaire (MLHFQ), 36-Item Short Form Health Survey (SF-36), and 6-min walking distance (6MWD) 1-month after TTVr. Mid-term mortality and heart failure (HF) hospitalization were assessed through 1 year. Results RVR was present in 137 of 223 patients (61%). Symptoms and QoL improved equally in both groups: ≥ 1 NYHA class (57% vs. 65% of patients with vs. without RVR, respectively), 6MWD (36% vs. 34%), MLHFQ (81% vs. 69%), and SF-36 (68% vs. 65%) improvement. One-year mortality and HF hospitalization were significantly higher in patients with RVR (24% and 30%, respectively) than in patients without (8% and 13%, both p < 0.05). In multivariable analysis, RVR was independently associated with mortality (HR 2.3, 95%CI (1.0–5.0), p = 0.04) and the combined endpoint of mortality or rehospitalization (HR 2.0, 95%CI (1.1–3.8), p = 0.03). Conclusions TTVr was associated with significant QoL improvement after 1 month, irrespective of RVR. Despite increased mortality and rehospitalization for heart failure, TTVr in the presence of RVR still provides substantial symptomatic benefit for patients with severe TR. Graphical abstract Role of preexisting right ventricular remodeling (RVR) in symptoms and prognosis after transcatheter tricuspid valve repair (TTVr).

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Health Status After Transcatheter Tricuspid Valve Repair in Patients With Functional Tricuspid Regurgitation

Cited by 13 publications

References 33 publications

A process-based approach to health-related quality of life as a “way of living”

A process-based approach to health-related quality of life as a “way of living”

Kathetergestützte Therapien der Trikuspidalklappe – Aktuelles jenseits der Leitlinien

Role of preexisting right ventricular remodeling in symptoms and prognosis after transcatheter tricuspid valve repair

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