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

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...

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Bibliographic Details
Published in:Cardiology journal 2024, Vol.31 (5), p.731-739
Main Authors: Rzucidło-Resil, Jolanta, Golińska-Grzybała, Karolina, Szlósarczyk, Barbara, Rostoff, Paweł, Gackowski, Andrzej, Gajos, Grzegorz, Kapelak, Bogusław, Stoliński, Jarosław
Format: Article
Language:English
Subjects:
Aged
Clinical Cardiology
Female
Heart Valve Prosthesis Implantation - adverse effects
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Humans
Male
Middle Aged
Mitral Valve - diagnostic imaging
Mitral Valve - physiopathology
Mitral Valve - surgery
Mitral Valve Insufficiency - diagnostic imaging
Mitral Valve Insufficiency - mortality
Mitral Valve Insufficiency - physiopathology
Mitral Valve Insufficiency - surgery
Mortality
Pulmonary arteries
Pulmonary Artery - diagnostic imaging
Pulmonary Artery - physiopathology
Pulmonary Artery - surgery
Retrospective Studies
Risk Factors
Surgery
Survival analysis
Time Factors
Treatment Outcome
Ventricular Function, Right - physiology
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Summary: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.
ISSN:1897-5593
1898-018X
1898-018X
DOI:10.5603/cj.92559