1. Prognostic Predictors of Tricuspid Regurgitation Worsening after Mitral Regurgitation Surgery with Mild Tricuspid Regurgitation.
- Author
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Hada, Tasuku, Amano, Masashi, Murata, Shunsuke, Nishimura, Kunihiro, Nakagawa, Shoko, Irie, Yuki, Moriuchi, Kenji, Okada, Atsushi, Kitai, Takeshi, Amaki, Makoto, Kanzaki, Hideaki, Fukushima, Satsuki, Kusano, Kengo, Noguchi, Teruo, Fujita, Tomoyuki, and Izumi, Chisato
- Abstract
We aimed to investigate the prevalence and predictors of postoperative tricuspid regurgitation (TR) worsening in patients with mitral regurgitation (MR) and concomitant ≤mild TR. A total of 620 patients underwent surgery for MR from 2013 to 2017. Of these, 260 had ≤mild preoperative TR and no concomitant tricuspid valve surgery and were enrolled in this single-center retrospective study. The primary endpoint was postoperative worsening of ≥moderate TR. The primary endpoint occurred in 28 of 260 patients (11%) during the follow-up period [median: 4.1 years (interquartile range: 2.9−6.1 years)]. In the multivariable analysis, age, female sex, and left atrial volume index (LAVI) were significant predictors of the primary outcome during intermediate-term follow-up (age: hazard ratio [HR] 1.05 per 1-year increment, 95% confidence interval [CI] 1.02–1.10, P = 0.003; female sex: HR 3.53, 95% CI 1.61–7.72, P = 0.002; LAVI: HR 1.17 per 10-mL/m
2 increment, 95% CI 1.07−1.26, P < 0.001). The optimal LAVI cut-off value for predicting postoperative TR worsening was 79 mL/m2 (area under the curve: 0.69). A high LAVI (>79 mL/m²) was significantly associated with a low rate of freedom from postoperative TR worsening compared with a low LAVI (≤79 mL/m²) (82.6% vs 93.9% at 5 years, respectively; log-rank P = 0.008). In patients with ≤mild preoperative TR and no concomitant tricuspid surgery, the rate of postoperative TR worsening was 11% during intermediate-term follow-up. LA enlargement in patients with MR and ≤mild preoperative TR was significantly associated with postoperative TR worsening. [Display omitted] [ABSTRACT FROM AUTHOR]- Published
- 2024
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