1. Ratio between right ventricular longitudinal strain and pulmonary arterial systolic pressure: A novel prognostic parameter in patients with severe tricuspid regurgitation.
- Author
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Ancona F, Margonato D, Menzà G, Bellettini M, Melillo F, Stella S, Capogrosso C, Ingallina G, Biondi F, Boccellino A, De Bonis M, Castiglioni A, Denti P, Maisano F, Alfieri O, Ancona MB, Montorfano M, Margonato, and Agricola E
- Subjects
- Humans, Female, Male, Prognosis, Blood Pressure, Echocardiography, Doppler, Retrospective Studies, Ventricular Function, Right physiology, Pulmonary Artery diagnostic imaging, Tricuspid Valve Insufficiency diagnostic imaging, Hypertension, Pulmonary, Heart Failure, Ventricular Dysfunction, Right
- Abstract
Background: In terms of pathophysiology, tricuspid regurgitation (TR), right ventricular function and pulmonary artery pressure are linked to each other. Our aim was to analyze whether the echocardiography-derived right ventricular free wall longitudinal strain/pulmonary artery systolic pressures (RVFWLS/PASP) ratio can improve risk stratification in patients with severe tricuspid regurgitation (TR)., Methods: In this single-center retrospective study, 250 consecutive patients with severe TR were enrolled from December 2015 to December 2018. Baseline clinical and echocardiographic parameters were collected. Echocardiography-derived TAPSE/PASP and RVFWLS/PASP were evaluated. The primary endpoint was all-cause mortality., Results: Out of 250 consecutive patients, 171 meet inclusion criteria. Patients were predominantly female, with several cardiovascular risk factors and comorbidities. RVFWLS/PASP ≤0.34%/mmHg (AUC 0.68, p < 0.001, sensitivity 70%, specificity 67%) was associated with baseline clinical RV heart failure (p = 0.03). After univariate and multivariate analyses, RVFWLS/PASP, but not TAPSE/PASP, independently correlated with all-cause mortality (HR 0.004, p = 0.02). Patients with RVFWLS/PASP >0.26%/mmHg (AUC 0.74, p < 0.001, sensitivity 77%, specificity 52%) showed higher survival rates (p = 0.02). In addition at 24 months follow-up, the Kaplan-Meyer curves showed patients with RVFWLS >14% & RVFWLS/PASP >0.26%/mmHg had the best survival rate compared to patients without., Conclusion: RVFWLS/PASP is independently associated with baseline RV heart failure and poor long-term prognosis in patients with severe TR., Competing Interests: Declaration of Competing Interest None. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Each author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
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