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Start Over Descriptor "right ventricle to pulmonary artery coupling" Publisher lippincott williams & wilkins
2 results on '"right ventricle to pulmonary artery coupling"'

1. Prognostic value of right ventricle to pulmonary artery coupling in transcatheter aortic valve implantation recipients

Author

Adamo, Marianna, Maccagni, Gloria, Fiorina, Claudia, Giannini, Cristina, Angelillis, Marco, Costa, Giulia, Trani, Carlo, Burzotta, Francesco, Bruschi, Giuseppe, Merlanti, Bruno, Poli, Arnaldo, Ferrara, Erica, Fineschi, Massimo, Iadanza, Alessandro, Chizzola, Giuliano, Metra, Marco, Trani, Carlo (ORCID:0000-0001-9777-013X), Burzotta, Francesco (ORCID:0000-0002-6569-9401), Adamo, Marianna, Maccagni, Gloria, Fiorina, Claudia, Giannini, Cristina, Angelillis, Marco, Costa, Giulia, Trani, Carlo, Burzotta, Francesco, Bruschi, Giuseppe, Merlanti, Bruno, Poli, Arnaldo, Ferrara, Erica, Fineschi, Massimo, Iadanza, Alessandro, Chizzola, Giuliano, Metra, Marco, Trani, Carlo (ORCID:0000-0001-9777-013X), and Burzotta, Francesco (ORCID:0000-0002-6569-9401)

Abstract

Aims To investigate the impact of the right ventricle to pulmonary artery (RV-PA) coupling on the outcome of patients undergoing transcatheter aortic valve intervention (TAVI), and to describe changes in right ventricular function, pulmonary hypertension, and their ratio after TAVI. Methods Three hundred and seventy-seven patients from the Italian ClinicalService Project, who underwent TAVI between February 2011 and August 2020, were included. Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio was retrospectively calculated as a surrogate of RV-PA coupling. The population was stratified according to TAPSE/PASP using a cut-off of 0.36 mm/mmHg derived from a receiving operating characteristic (ROC) curve. The primary end point was 6-month all-cause death. Results Compared with patients with a TAPSE/PASP ratio >= 0.36 mm/mmHg (81%), those with TAPSE/PASP ratio <0.36 mm/mmHg (19%) had more comorbidities and were more symptomatic. Moreover, they were more likely to receive general anesthesia and an old generation device. Device success was similar between the two groups. A TAPSE/PASP ratio <0.36 mm/mmHg was associated with a higher risk of all-cause death at 6-months (17.3% versus 5.3%; adjusted HR 2.66; P = 0.041). The prognostic impact of the TAPSE/PASP ratio was stronger than the impact of TAPSE and PASP as separate parameters and was independent of the surgical risk score. Both TAPSE, PASP, and their ratio improved from baseline to 1 month and 6 months after TAVI. Conclusions A TAPSE/PASP ratio <0.36 mm/mmHg is strongly associated with an increased risk of mortality after TAVI. Providing a left ventricle unloading, TAVI is associated with improvement of both TAPSE, PASP, and their ratio.

Published
2022

2. Prognostic value of right ventricle to pulmonary artery coupling in transcatheter aortic valve implantation recipients

Author

Marianna Adamo, Gloria Maccagni, Claudia Fiorina, Cristina Giannini, Marco Angelillis, Giulia Costa, Carlo Trani, Francesco Burzotta, Giuseppe Bruschi, Bruno Merlanti, Arnaldo Poli, Erica Ferrara, Massimo Fineschi, Alessandro Iadanza, Giuliano Chizzola, and Marco Metra

Subjects
Heart Failure, Heart Ventricles, Ventricular Dysfunction, Right, Doppler, General Medicine, Pulmonary Artery, Prognosis, mortality, Echocardiography, Doppler, Transcatheter Aortic Valve Replacement, Right, right ventricle to pulmonary artery coupling, transcatheter aortic valve implantation, Humans, Retrospective Studies, Ventricular Function, Right, Echocardiography, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Ventricular Dysfunction, Ventricular Function, Cardiology and Cardiovascular Medicine
Abstract

To investigate the impact of the right ventricle to pulmonary artery (RV-PA) coupling on the outcome of patients undergoing transcatheter aortic valve intervention (TAVI), and to describe changes in right ventricular function, pulmonary hypertension, and their ratio after TAVI.Three hundred and seventy-seven patients from the Italian ClinicalService Project, who underwent TAVI between February 2011 and August 2020, were included. Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio was retrospectively calculated as a surrogate of RV-PA coupling. The population was stratified according to TAPSE/PASP using a cut-off of 0.36 mm/mmHg derived from a receiving operating characteristic (ROC) curve. The primary end point was 6-month all-cause death.Compared with patients with a TAPSE/PASP ratio ≥0.36 mm/mmHg (81%), those with TAPSE/PASP ratio0.36 mm/mmHg (19%) had more comorbidities and were more symptomatic.Moreover, they were more likely to receive general anesthesia and an old generation device. Device success was similar between the two groups. A TAPSE/PASP ratio0.36 mm/mmHg was associated with a higher risk of all-cause death at 6-months (17.3% versus 5.3%; adjusted HR 2.66; P = 0.041). The prognostic impact of the TAPSE/PASP ratio was stronger than the impact of TAPSE and PASP as separate parameters and was independent of the surgical risk score. Both TAPSE, PASP, and their ratio improved from baseline to 1 month and 6 months after TAVI.A TAPSE/PASP ratio0.36 mm/mmHg is strongly associated with an increased risk of mortality after TAVI. Providing a left ventricle unloading, TAVI is associated with improvement of both TAPSE, PASP, and their ratio.

Published
2022

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