Right Ventricular Contraction Patterns in Patients Undergoing Transcatheter Tricuspid Valve Repair for Severe Tricuspid Regurgitation

Kresoja, Karl‐Patrik; Rommel, Karl‐Philipp; Lücke, Christian; Unterhuber, Matthias; Besler, Christian; Roeder, Maximilian von; Schöber, Anne Rebecca; Noack, Thilo; Gutberlet, Matthias; Thiele, Holger; Lurz, Philipp

doi:10.1016/j.jcin.2021.05.005

Cited by 71 publications

(54 citation statements)

References 19 publications

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“…18 This would explain per se the worse prognosis regardless of haemodynamic conditions. At variance with very recent findings by the same group focusing on different patterns of longitudinal vs. meridional RV function and outcome before TTVR, 19 the present data point against a main role in outcome difference of the right heart and pulmonary vascular disease given a comparable RV to pulmonary circulation uncoupling as assessed by th tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio. This finding is quite surprising and remains of not easy interpretation.…”

contrasting

confidence: 86%

Cardiac output in severe tricuspid regurgitation: when more is less

Guazzi

Adamo

2021

European J of Heart Fail

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contrasting

confidence: 86%

Cardiac output in severe tricuspid regurgitation: when more is less

Guazzi

Adamo

2021

European J of Heart Fail

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“…RV contraction patterns can also be characterized by cardiac magnetic resonance imaging, and severe global RV dysfunction was a strong predictor of mortality in patients undergoing TTVr. 10 Further studies are needed to characterize more precisely the incidence and clinical impact of afterload mismatch after TTVr and the relationship with RV function and long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Acute Afterload Mismatch After Transcatheter Tricuspid Valve Repair

et al. 2022

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“…Accordingly, we assessed 3D global function and found that patients with severe TR had significantly lower RV EF along with markedly decreased RV GLS and GCS compared to those without. Interestingly, several studies have shown that global RV EF could remain preserved at the first stages in patients with severe TR and left-sided heart diseases despite the significant decline in longitudinal function (5,23). The maintained RV plasticity could explain this at the tion in RV function by quantifying the traction of the LV free wall to the RV insertion points (5).…”

Section: Discussionmentioning

confidence: 99%

Tricuspid regurgitation and right ventricular contraction pattern in heart failure with reduced ejection fraction: a 3D echocardiography study

Shiida¹,

Ujvári²,

Lakatos³

et al. 2022

Cardiologia Hungarica

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The development of secondary tricuspid regurgitation (TR) is associated with poor outcomes in patients with heart failure and reduced left ventricular (LV) ejection fraction (HFrEF). Data are scarce concerning the right ventricular (RV) morphological and functional remodeling in HFrEF in relation to the severity of TR. Accordingly, we aimed to characterize RV remodeling in HFrEF patients with and without significant TR using three-dimensional (3D) echocardiography. We retrospectively identified 138 patients with HFrEF. In this cohort, we graded TR severity according to current guidelines and compared patients with no to mild TR (non-significant TR, n=78) versus patients with moderate to severe TR (significant TR, n=60). All patients underwent clinically indicated 3D transthoracic echocardiography. 3D LV and RV end-diastolic volumes (EDVi) and ejection fractions (EF) were measured. To characterize RV mechanical pattern, the ReVISION method was used to quantify the contribution of the longitudinal, radial, and anteroposterior motion components to total RV EF. Patients with significant TR had higher LV EDVi and lower LV EF compared with patients with non-significant TR (LV EDVi: 117.2±34.9 vs. 102.6±39.6 ml/m2; LV EF: 27.0±6.6 vs. 30.2±7.7%, both p<0.05). Concerning the right heart, RV EDVi was significantly higher in patients with significant TR compared with those without (92.1±32.4 vs. 74.1±26.9 ml/m2; p<0.01). RV EF was lower in patients with significant TR (36±10.3 vs. 42.5±9.3%, p<0.05). Regarding RV mechanics, anteroposterior and longitudinal components were significantly decreased in patients with significant TR compared with patients with non-significant TR (anteroposterior relative contribution: 10.0±4.5 vs. 11.7±3.7%; longitudinal: 8.2±3.8 vs. 11.1±3.8%; both p<0.05). On the other hand, the radial component did not show a difference between patients with or without significant TR (17.8±6.9 vs. 19.8±6.2%; p=NS). By assessing RV mechanics using 3D echocardiography, we have shown that HFrEF patients with significant TR presented with reduced RV global function, mainly attributable to the deterioration of the longitudinal and anteroposterior motion components. Identification of the turning point where RV plasticity diminishes, and significant TR develops would be of high clinical interest for more tailored therapeutic decisions.

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Right Ventricular Contraction Patterns in Patients Undergoing Transcatheter Tricuspid Valve Repair for Severe Tricuspid Regurgitation

Cited by 71 publications

References 19 publications

Cardiac output in severe tricuspid regurgitation: when more is less

Cardiac output in severe tricuspid regurgitation: when more is less

Acute Afterload Mismatch After Transcatheter Tricuspid Valve Repair

Tricuspid regurgitation and right ventricular contraction pattern in heart failure with reduced ejection fraction: a 3D echocardiography study

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