Improvement in nutritional status – a determinant of successful transcatheter tricuspid valve repair?

Schneider, Matthias; Mascherbauer, Julia

doi:10.1002/ejhf.1794

Cited by 1 publication

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References 15 publications

(28 reference statements)

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“…Future studies should focus on more comprehensive parameters, particularly indexed 3D end-diastolic RV volume which can be derived in most patients if hardware and software are available [ 19 ]. In addition, particular attention should be paid towards associated organ damage, such as renal and liver dysfunction [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

Schneider

König

Geller

et al. 2021

JCM

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Background: Presence of severe tricuspid regurgitation (TR) has a significant impact on assessment of right ventricular function (RVF) in transthoracic echocardiography (TTE). High trans-valvular pendulous volume leads to backward-unloading of the right ventricle. Consequently, established cut-offs for normal systolic performance may overestimate true systolic RVF. Methods: A retrospective analysis was performed entailing all patients who underwent TTE at our institution between 1 January 2013 and 31 December 2016. Only patients with normal left ventricular systolic function and with no other valvular lesion were included. All recorded loops were re-read by one experienced examiner. Patients without severe TR (defined as vena contracta width ≥7 mm) were excluded. All-cause 2-year mortality was chosen as the end-point. The prognostic value of several RVF parameters was tested. Results: The final cohort consisted of 220 patients, 88/220 (40%) were male. Median age was 69 years (IQR 52–79), all-cause two-year mortality was 29%, median TAPSE was 19 mm (15–22) and median FAC was 42% (30–52). In multivariate analysis, TAPSE with the cutoff 17 mm and FAC with the cutoff 35% revealed non-significant hazard ratios (HR) of 0.75 (95%CI 0.396–1.421, p = 0.38) and 0.845 (95%CI 0.383–1.867, p = 0.68), respectively. TAPSE with the cutoff 19 mm and visual eyeballing significantly predicted survival with HRs of 0.512 (95%CI 0.296–0.886, p = 0.017) and 1.631 (95%CI 1.101–2.416, p = 0.015), respectively. Conclusions: This large-scale all-comer study confirms that RVF is one of the main drivers of mortality in patients with severe isolated TR. However, the current cut-offs for established echocardiographic parameters did not predict survival. Further studies should investigate the prognostic value of higher thresholds for RVF parameters in these patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

Schneider

König

Geller

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

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Improvement in nutritional status – a determinant of successful transcatheter tricuspid valve repair?

Abstract: This article refers to 'Nutritional status in tricuspid regurgitation: implications of transcatheter repair' by C. Besler et al., published in this issue on pages 1826-1836.

Cited by 1 publication

References 15 publications

Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

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