Pacemaker lead-associated tricuspid regurgitation in patients with or without pre-existing right ventricular dilatation.
Aged
Cardiomyopathy, Dilated
/ physiopathology
Echocardiography
Equipment Failure
Female
Follow-Up Studies
Humans
Male
Pacemaker, Artificial
/ adverse effects
Prognosis
Retrospective Studies
Tricuspid Valve
/ diagnostic imaging
Tricuspid Valve Insufficiency
/ diagnosis
Ventricular Dysfunction, Right
/ diagnosis
Device complications
Pacemaker
Right ventricle
Tricuspid regurgitation
Valvular heart disease
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
12
11
2020
accepted:
28
01
2021
pubmed:
11
2
2021
medline:
19
11
2021
entrez:
10
2
2021
Statut:
ppublish
Résumé
Transcatheter tricuspid valve intervention became an option for pacemaker lead-associated tricuspid regurgitation. This study investigated the progression of tricuspid regurgitation (TR) in patients with or without pre-existing right ventricular dilatation (RVD) undergoing pacemaker implantation. Patients were included if they had implantation of transtricuspid pacemaker lead and completed echocardiography before and after implantation. The cohort was divided in patients with and without RVD (cut-off basal RV diameter ≥ 42 mm). TR was graded in none/mild, moderate, and severe. Worsening of one grade was defined as progression. Survival analyses were plotted for 10 years. In total, 990 patients were analyzed (24.5% with RVD). Progression of TR occurred in 46.1% of patients with RVD and in 25.6% of patients without RVD (P < 0.001). Predictors for TR progression were RV dilatation (OR 2.04; 95% CI 1.27-3.29; P = 0.003), pre-existing TR (OR 4.30; 95% CI 2.51-7.38; P < 0.001), female sex (OR 1.68; 95% CI 1.16-2.43; P = 0.006), single RV lead (OR 1.67; 95% CI 1.09-2.56; P = 0.018), mitral regurgitation (OR 2.08; 95% CI 1.42-3.05; P < 0.001), and enlarged left atrium (OR 1.98; 95% CI 1.07-3.67; P = 0.03). Survival-predictors were pacemaker lead-associated TR (HR 1.38; 95% CI 1.04-1.84; P = 0.028), mitral regurgitation (HR 1.34; 95% CI 1.02-1.77; P = 0.034), heart failure (HR 1.75; 95% CI 1.31-2.33; P < 0.001), kidney disease (HR 1.62; 95% CI 1.25-2.11; P < 0.001), and age ≥ 80 years (HR 2.84; 95% CI 2.17-3.71; P < 0.001). Patients with RVD receiving pacemaker suffered from increased TR progression, leading to decreased survival.
Sections du résumé
BACKGROUND
BACKGROUND
Transcatheter tricuspid valve intervention became an option for pacemaker lead-associated tricuspid regurgitation. This study investigated the progression of tricuspid regurgitation (TR) in patients with or without pre-existing right ventricular dilatation (RVD) undergoing pacemaker implantation.
METHODS
METHODS
Patients were included if they had implantation of transtricuspid pacemaker lead and completed echocardiography before and after implantation. The cohort was divided in patients with and without RVD (cut-off basal RV diameter ≥ 42 mm). TR was graded in none/mild, moderate, and severe. Worsening of one grade was defined as progression. Survival analyses were plotted for 10 years.
RESULTS
RESULTS
In total, 990 patients were analyzed (24.5% with RVD). Progression of TR occurred in 46.1% of patients with RVD and in 25.6% of patients without RVD (P < 0.001). Predictors for TR progression were RV dilatation (OR 2.04; 95% CI 1.27-3.29; P = 0.003), pre-existing TR (OR 4.30; 95% CI 2.51-7.38; P < 0.001), female sex (OR 1.68; 95% CI 1.16-2.43; P = 0.006), single RV lead (OR 1.67; 95% CI 1.09-2.56; P = 0.018), mitral regurgitation (OR 2.08; 95% CI 1.42-3.05; P < 0.001), and enlarged left atrium (OR 1.98; 95% CI 1.07-3.67; P = 0.03). Survival-predictors were pacemaker lead-associated TR (HR 1.38; 95% CI 1.04-1.84; P = 0.028), mitral regurgitation (HR 1.34; 95% CI 1.02-1.77; P = 0.034), heart failure (HR 1.75; 95% CI 1.31-2.33; P < 0.001), kidney disease (HR 1.62; 95% CI 1.25-2.11; P < 0.001), and age ≥ 80 years (HR 2.84; 95% CI 2.17-3.71; P < 0.001).
CONCLUSIONS
CONCLUSIONS
Patients with RVD receiving pacemaker suffered from increased TR progression, leading to decreased survival.
Identifiants
pubmed: 33566185
doi: 10.1007/s00392-021-01812-3
pii: 10.1007/s00392-021-01812-3
pmc: PMC8166708
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
884-894Subventions
Organisme : H2020 Future and Emerging Technologies
ID : 732170
Références
Topilsky Y, Maltais S, Medina Inojosa J et al (2019) Burden of tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging 12:433–442. https://doi.org/10.1016/j.jcmg.2018.06.014
doi: 10.1016/j.jcmg.2018.06.014
pubmed: 30121261
Rodés-Cabau J, Taramasso M, O’Gara PT (2016) Diagnosis and treatment of tricuspid valve disease: current and future perspectives. Lancet 388:2431–2442. https://doi.org/10.1016/S0140-6736(16)00740-6
doi: 10.1016/S0140-6736(16)00740-6
pubmed: 27048553
Nath J, Foster E, Heidenreich PA (2004) Impact of tricuspid regurgitation on long-term survival. J Am Coll Cardiol 43:405–409. https://doi.org/10.1016/j.jacc.2003.09.036
doi: 10.1016/j.jacc.2003.09.036
pubmed: 15013122
Nishimura RA, Otto CM, Bonow RO et al (2017) 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease. J Am Coll Cardiol 70:252–289. https://doi.org/10.1016/j.jacc.2017.03.011
doi: 10.1016/j.jacc.2017.03.011
pubmed: 28315732
Baumgartner H, Falk V, Bax JJ et al (2017) 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J 38:2739–2791. https://doi.org/10.1093/eurheartj/ehx391
doi: 10.1093/eurheartj/ehx391
pubmed: 28886619
Asmarats L, Puri R, Latib A et al (2018) Transcatheter tricuspid valve interventions. J Am Coll Cardiol 71:2935–2956. https://doi.org/10.1016/j.jacc.2018.04.031
doi: 10.1016/j.jacc.2018.04.031
pubmed: 29929618
Taramasso M, Pozzoli A, Guidotti A et al (2016) Percutaneous tricuspid valve therapies: the new frontier. Eur Heart J. https://doi.org/10.1093/eurheartj/ehv766
doi: 10.1093/eurheartj/ehv766
pubmed: 27371718
Taramasso M, Alessandrini H, Latib A et al (2019) Outcomes after current transcatheter tricuspid valve intervention. JACC Cardiovasc Interv 12:155–165. https://doi.org/10.1016/j.jcin.2018.10.022
doi: 10.1016/j.jcin.2018.10.022
pubmed: 30594510
Nickenig G, Weber M, Schueler R et al (2019) 6-Month outcomes of tricuspid valve reconstruction for patients with severe tricuspid regurgitation. J Am Coll Cardiol 73:1905–1915. https://doi.org/10.1016/j.jacc.2019.01.062
doi: 10.1016/j.jacc.2019.01.062
pubmed: 30999993
Orban M, Rommel K-P, Ho EC et al (2020) Transcatheter edge-to-edge tricuspid repair for severe tricuspid regurgitation reduces hospitalizations for heart failure. JACC Heart Fail 8:265–276. https://doi.org/10.1016/j.jchf.2019.12.006
doi: 10.1016/j.jchf.2019.12.006
pubmed: 32241534
Addetia K, Harb SC, Hahn RT et al (2019) Cardiac implantable electronic device lead-induced tricuspid regurgitation. JACC Cardiovasc Imaging 12:622–636. https://doi.org/10.1016/j.jcmg.2018.09.028
doi: 10.1016/j.jcmg.2018.09.028
pubmed: 30947905
Chang JD, Manning WJ, Ebrille E, Zimetbaum PJ (2017) Tricuspid valve dysfunction following pacemaker or cardioverter-defibrillator implantation. J Am Coll Cardiol 69:2331–2341. https://doi.org/10.1016/j.jacc.2017.02.055
doi: 10.1016/j.jacc.2017.02.055
pubmed: 28473139
Arabi P, Özer N, Ateş AH et al (2015) Effects of pacemaker and implantable cardioverter defibrillator electrodes on tricuspid regurgitation and right sided heart functions. Cardiol J 22:637–644. https://doi.org/10.5603/CJ.a2015.0060
doi: 10.5603/CJ.a2015.0060
pubmed: 26412607
Al-Bawardy R, Krishnaswamy A, Rajeswaran J et al (2015) Tricuspid regurgitation and implantable devices: TR AND IMPLANTABLE DEVICES. Pacing Clin Electrophysiol 38:259–266. https://doi.org/10.1111/pace.12530
doi: 10.1111/pace.12530
pubmed: 25377489
Delling FN, Hassan ZK, Piatkowski G et al (2016) Tricuspid regurgitation and mortality in patients with transvenous permanent pacemaker leads. Am J Cardiol 117:988–992. https://doi.org/10.1016/j.amjcard.2015.12.038
doi: 10.1016/j.amjcard.2015.12.038
pubmed: 26833208
pmcid: 4775321
Höke U, Auger D, Thijssen J et al (2014) Significant lead-induced tricuspid regurgitation is associated with poor prognosis at long-term follow-up. Heart 100:960–968. https://doi.org/10.1136/heartjnl-2013-304673
doi: 10.1136/heartjnl-2013-304673
pubmed: 24449717
Seo J, Kim D-Y, Cho I et al (2020) Prevalence, predictors, and prognosis of tricuspid regurgitation following permanent pacemaker implantation. PLoS ONE 15:e0235230. https://doi.org/10.1371/journal.pone.0235230
doi: 10.1371/journal.pone.0235230
pubmed: 32589674
pmcid: 7319337
Papageorgiou N, Falconer D, Wyeth N et al (2020) Effect of tricuspid regurgitation and right ventricular dysfunction on long-term mortality in patients undergoing cardiac devices implantation: > 10-year follow-up study. Int J Cardiol. https://doi.org/10.1016/j.ijcard.2020.05.062
doi: 10.1016/j.ijcard.2020.05.062
pubmed: 32470533
Seo Y, Nakajima H, Ishizu T et al (2020) Comparison of outcomes in patients with heart failure with versus without lead-induced tricuspid regurgitation after cardiac implantable electronic devices implantations. Am J Cardiol 130:85–93. https://doi.org/10.1016/j.amjcard.2020.05.039
doi: 10.1016/j.amjcard.2020.05.039
pubmed: 32622503
Nazmul MN, Cha Y-M, Lin G et al (2013) Percutaneous pacemaker or implantable cardioverter-defibrillator lead removal in an attempt to improve symptomatic tricuspid regurgitation. EP Eur 15:409–413. https://doi.org/10.1093/europace/eus342
doi: 10.1093/europace/eus342
Taramasso M, Gavazzoni M, Pozzoli A et al (2020) Outcomes of TTVI in patients with pacemaker or defibrillator leads. JACC Cardiovasc Interv 13:554–564. https://doi.org/10.1016/j.jcin.2019.10.058
doi: 10.1016/j.jcin.2019.10.058
pubmed: 31954676
Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–271. https://doi.org/10.1093/ehjci/jev014
doi: 10.1093/ehjci/jev014
pubmed: 25712077
Rudski LG, Lai WW, Afilalo J et al (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography. J Am Soc Echocardiogr 23:685–713. https://doi.org/10.1016/j.echo.2010.05.010
doi: 10.1016/j.echo.2010.05.010
pubmed: 20620859
Lancellotti P, Tribouilloy C, Hagendorff A et al (2013) Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 14:611–644. https://doi.org/10.1093/ehjci/jet105
doi: 10.1093/ehjci/jet105
pubmed: 23733442
Schneider M, Binder T (2018) Echocardiographic evaluation of the right heart. Wien Klin Wochenschr 130:413–420. https://doi.org/10.1007/s00508-018-1330-3
doi: 10.1007/s00508-018-1330-3
pubmed: 29556779
pmcid: 6061659
Kim JB, Spevack DM, Tunick PA et al (2008) The effect of transvenous pacemaker and implantable cardioverter defibrillator lead placement on tricuspid valve function: an observational study. J Am Soc Echocardiogr 21:284–287. https://doi.org/10.1016/j.echo.2007.05.022
doi: 10.1016/j.echo.2007.05.022
pubmed: 17604958
Klutstein M, Balkin J, Butnaru A et al (2009) Tricuspid incompetence following permanent pacemaker implantation. Pacing Clin Electrophysiol 32:S135–S137. https://doi.org/10.1111/j.1540-8159.2008.02269.x
doi: 10.1111/j.1540-8159.2008.02269.x
pubmed: 19250077
Dickstein K, Normand C, Auricchio A et al (2018) CRT Survey II: a European Society of Cardiology survey of cardiac resynchronisation therapy in 11 088 patients-who is doing what to whom and how? CRT Survey II. Eur J Heart Fail 20:1039–1051. https://doi.org/10.1002/ejhf.1142
doi: 10.1002/ejhf.1142
pubmed: 29457358
Cho MS, Kim J, Lee J-B et al (2019) Incidence and predictors of moderate to severe tricuspid regurgitation after dual-chamber pacemaker implantation. Pacing Clin Electrophysiol 42:85–92. https://doi.org/10.1111/pace.13543
doi: 10.1111/pace.13543
pubmed: 30417396
Najib MQ, Vinales KL, Vittala SS et al (2012) Predictors for the development of severe tricuspid regurgitation with anatomically normal valve in patients with atrial fibrillation: severe functional TR in AF. Echocardiography 29:140–146. https://doi.org/10.1111/j.1540-8175.2011.01565.x
doi: 10.1111/j.1540-8175.2011.01565.x
pubmed: 22067002
Lee RC, Friedman SE, Kono AT et al (2015) Tricuspid regurgitation following implantation of endocardial leads: incidence and predictors: tricuspid regurgitation following endocardial leads. Pacing Clin Electrophysiol 38:1267–1274. https://doi.org/10.1111/pace.12701
doi: 10.1111/pace.12701
pubmed: 26234305
Beurskens NEG, Tjong FVY, de Bruin-Bon RHA et al (2019) Impact of leadless pacemaker therapy on cardiac and atrioventricular valve function through 12 months of follow-up. Circ Arrhythm Electrophysiol. https://doi.org/10.1161/CIRCEP.118.007124
doi: 10.1161/CIRCEP.118.007124
pubmed: 31266354
Andreas M, Gremmel F, Habertheuer A et al (2015) Case report: pacemaker lead perforation of a papillary muscle inducing severe tricuspid regurgitation. J Cardiothorac Surg. https://doi.org/10.1186/s13019-015-0244-7
doi: 10.1186/s13019-015-0244-7
pubmed: 25928192
pmcid: 4423145