Right ventricle to pulmonary artery coupling as a predictor of perioperative outcome in patients with secondary mitral valve insufficiency.

TAPSE/RVSP ratio mitral valve surgery secondary mitral regurgitation

Journal

Cardiology journal
ISSN: 1898-018X
Titre abrégé: Cardiol J
Pays: Poland
ID NLM: 101392712

Informations de publication

Date de publication:
29 Sep 2023
Historique:
received: 04 11 2022
accepted: 27 07 2023
revised: 13 06 2023
medline: 29 9 2023
pubmed: 29 9 2023
entrez: 29 9 2023
Statut: aheadofprint

Résumé

The aim of the study was to assess some parameters of right ventricle (RV) function as predictors of short-term mortality in patients with severe secondary mitral regurgitation (SMR) after mitral valve surgery. We conducted a retrospective analysis of 112 consecutive patients with severe SMR who had undergone mitral valve repair or replacement with or without concomitant coronary artery bypass surgery. We assessed RV to pulmonary artery coupling by calculating the ratio of tricuspid annular plane systolic excursion (TAPSE) to non-invasively estimated RV systolic pressure (RVSP). The study endpoint was 30 days post-procedural mortality. Overall, the 30-day mortality was 6%. TAPSE/RVSP ratio < 0.42 mm/mmHg was a significant predictor of mortality and remained so after adjusting for age and sex. The Kaplan-Meier survival analysis showed that patients with RVSP > 55 mmHg and those with TAPSE/RVSP ratio < 0.42 mm/mmHg had a lower survival probability. TAPSE/RVSP < 0.42 mm/mmHg is a strong predictor of short-term mortality in patients with SMR when considered for valve surgery.

Sections du résumé

BACKGROUND BACKGROUND
The aim of the study was to assess some parameters of right ventricle (RV) function as predictors of short-term mortality in patients with severe secondary mitral regurgitation (SMR) after mitral valve surgery.
METHODS METHODS
We conducted a retrospective analysis of 112 consecutive patients with severe SMR who had undergone mitral valve repair or replacement with or without concomitant coronary artery bypass surgery. We assessed RV to pulmonary artery coupling by calculating the ratio of tricuspid annular plane systolic excursion (TAPSE) to non-invasively estimated RV systolic pressure (RVSP). The study endpoint was 30 days post-procedural mortality.
RESULTS RESULTS
Overall, the 30-day mortality was 6%. TAPSE/RVSP ratio < 0.42 mm/mmHg was a significant predictor of mortality and remained so after adjusting for age and sex. The Kaplan-Meier survival analysis showed that patients with RVSP > 55 mmHg and those with TAPSE/RVSP ratio < 0.42 mm/mmHg had a lower survival probability.
CONCLUSIONS CONCLUSIONS
TAPSE/RVSP < 0.42 mm/mmHg is a strong predictor of short-term mortality in patients with SMR when considered for valve surgery.

Identifiants

pubmed: 37772356
pii: VM/OJS/J/92559
doi: 10.5603/cj.92559
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Auteurs

Jolanta Rzucidło-Resil (J)

Department of Noninvasive Cardiovascular Laboratory, the St. John P aul II Hospital, Krakow, Poland. resil@onet.eu.

Karolina Golińska-Grzybała (K)

Department of Noninvasive Cardiovascular Laboratory, the St. John P aul II Hospital, Krakow, Poland.

Barbara Szlósarczyk (B)

Department of Coronary Disease and Heart Failure, the St. John Paul II Hospital, Krakow, Poland.

Paweł Rostoff (P)

Department of Coronary Disease and Heart Failure, the St. John Paul II Hospital, Krakow, Poland.
Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.

Andrzej Gackowski (A)

Department of Noninvasive Cardiovascular Laboratory, the St. John P aul II Hospital, Krakow, Poland.
Department of Coronary Disease and Heart Failure, the St. John Paul II Hospital, Krakow, Poland.
Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.

Grzegorz Gajos (G)

Department of Coronary Disease and Heart Failure, the St. John Paul II Hospital, Krakow, Poland.
Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.

Bogusław Kapelak (B)

Department of Cardiovascular Surgery and Transplantology, the St. John P aul II Hospital, Krakow, Poland.
Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.

Jarosław Stoliński (J)

Department of Cardiovascular Surgery and Transplantology, the St. John P aul II Hospital, Krakow, Poland.
Andrzej Frycz Modrzewski Krakow University, Faculty of Medicine and Health Sciences, Krak ow, Poland.

Classifications MeSH