Risk Factors for Progression of Functional Tricuspid Regurgitation

Shiran, Avinoam; Najjar, Riham; Adawi, Salim; Aronson, Doron

doi:10.1016/j.amjcard.2013.11.055

Cited by 62 publications

(33 citation statements)

References 30 publications

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“…33,34 AF in the setting of TR may reflect and at the same time facilitate further negative structural remodeling as a component of severe end-stage TR. AF may cause parallel annular and RA enlargement, which in turn facilitate more AF.…”

Section: Discussionmentioning

confidence: 97%

Pathogenic structural heart changes in early tricuspid regurgitation

Nemoto

Lesser

Pedersen

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 97%

Pathogenic structural heart changes in early tricuspid regurgitation

Nemoto

Lesser

Pedersen

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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“…Conservative treatment options are limited, and redo surgery carries a high risk . Previous studies showed that sPAP increase and permanent AF were the most powerful risk factors for TR progression in patients with low prevalence of rheumatic heart disease and preserved LVEF . Our PSM analysis demonstrates that overall survival, reoperation, and moderate‐to‐severe TR in ablated patients were better than those in nonablated patients.…”

Section: Discussionmentioning

confidence: 64%

“…26,27 Previous studies showed that sPAP increase and permanent AF were the most powerful risk factors for TR progression in patients with low prevalence of rheumatic heart disease and preserved LVEF. 2,28 Our PSM analysis demonstrates that overall survival, reoperation, and moderate-to-severe TR in ablated patients were better than those in nonablated patients. TR was a significant and leading cause of reoperation in the nonablated group in the first 10-year followup, whereas patients in the ablated group had a significant lower risk of reoperation for TR in the follow-up.…”

Section: Discussionmentioning

confidence: 81%

Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis

Wang

Han

et al. 2016

JAHA

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BackgroundThis study assessed the role of surgical ablation for atrial fibrillation (AF) in decreasing tricuspid regurgitation (TR) and right‐sided heart remodeling in patients after mitral valve procedure.Methods and ResultsBetween 1994 and 2014, 1568 consecutive patients with AF undergoing mitral valve procedure were identified. In 26.0% (n=408), surgical ablation of AF was used. Propensity‐score matching (PSM) was performed on the basis of 41 known perioperative risk variables. Survival, reoperation, stroke, and moderate‐to‐severe TR, as well as echocardiography indices in long‐term follow‐up, were compared in 406 matched patient pairs (ablated and nonablated groups). The nonablated group showed significantly higher risks of death (hazard ratio [HR], 1.644; 95% CI, 1.081–2.501; P=0.020), reoperation (HR, 2.644; 95% CI, 1.299–5.466; P=0.008), and moderate‐to‐severe TR (HR, 1.436; 95% CI, 1.059–1.948; P=0.020), associated with a significantly deteriorated cardiac function, progression of TR, and right‐sided heart remodeling after 5‐year follow‐up. In a subgroup comparison of ablated patients with sinus rhythm versus AF recurrence, a PSM analysis was performed at the 5‐year follow‐up. The recurrent group showed significantly higher risks of moderate‐to‐severe TR (HR, 2.427; 95% CI, 1.261–4.671; P=0.008). AF recurrence was associated with progressive TR and significant deterioration in right‐sided heart remodeling.ConclusionsIn a retrospective PSM analysis, mitral valve disease with AF was associated with TR progression as well as right‐sided heart remodeling, which are alleviated by surgical ablation.

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“…In patients with native TV, permanent atrial fibrillation is a powerful independent predictor of progression of TV regurgitation from mild or less to moderate or greater. 12 It is postulated that atrial fibrillation leads to loss of atrial mechanical activity causing atrial dilatation that in turn leads to annular dilatation and remodeling. Indeed, this effect of atrial fibrillation is more pronounced on the TV than the mitral valve.…”

Section: Ta B L E 1 Patient Characteristics By Different Lead Typesmentioning

confidence: 99%