The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant / 医学前沿
Frontiers of Medicine
;
(4): 527-533, 2023.
Artigo
em Inglês
| WPRIM
| ID: wpr-982579
ABSTRACT
In this study, we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation (TR), taking into account its dynamic nature, after biatrial orthotopic heart transplant (OHT). All consecutive adult patients undergoing biatrial OHT (1984-2017) with an available follow-up echocardiogram were included. Mixed-models were used to model the evolution of TR. The mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with mortality. In total, 572 patients were included (median age 50 years, males 74.9%). Approximately 32% of patients had moderate-to-severe TR immediately after surgery. However, this declined to 11% on 5 years and 9% on 10 years after surgery, adjusted for survival bias. Pre-implant mechanical support was associated with less TR during follow-up, whereas concurrent LV dysfunction was significantly associated with more TR during follow-up. Survival at 1, 5, 10, 20 years was 97% ± 1%, 88% ± 1%, 66% ± 2% and 23% ± 2%, respectively. The presence of moderate-to-severe TR during follow-up was associated with higher mortality (HR 1.07, 95% CI (1.02-1.12), p = 0.006). The course of TR was positively correlated with the course of creatinine (R = 0.45). TR during follow-up is significantly associated with higher mortality and worse renal function. Nevertheless, probability of TR is the highest immediately after OHT and decreases thereafter. Therefore, it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Insuficiência da Valva Tricúspide
/
Ecocardiografia
/
Estudos Retrospectivos
/
Transplante de Coração
/
Resultado do Tratamento
/
Disfunção Ventricular Esquerda
Limite:
Adulto
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Frontiers of Medicine
Ano de publicação:
2023
Tipo de documento:
Artigo
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