Universität zu Köln

Sugiura, Atsushi, Kavsur, Refik, Spieker, Maximilian, Iliadis, Christos, Mauri, Victor, Tanaka, Tetsu ORCID: 0000-0003-0780-8689, Goto, Tadahiro, Weber, Marcel, Kelm, Malte, Baldus, Stephan, Nickenig, Georg, Westenfeld, Ralf, Pfister, Roman and Becher, Marc Ulrich (2022). Impact of right ventricular-pulmonary arterial coupling on clinical outcomes of tricuspid regurgitation. EuroIntervention, 18 (10). S. 852 - 869. TOULOUSE CEDEX 6: EUROPA EDITION. ISSN 1969-6213

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Abstract

Background: In terms of pathophysiology, tricuspid regurgitation (TR) and right ventricular (RV) function are linked to each other. Aims: This study sought to evaluate RV-pulmonary artery (PA) coupling and its impact on clinical out-comes of TR in patients undergoing mitral transcatheter edge-to-edge repair (TEER). Methods: We calculated RV-PA coupling ratios in patients undergoing mitral TEER from August 2010 to March 2019 by dividing the tricuspid annular plane systolic excursion (TAPSE) by the echocardiographic estimated PA systolic pressure (PASP). TR was graded as none/trace, mild, moderate, or severe. The pri-mary outcome was all-cause mortality or rehospitalisation within 12 months. Results: Among 744 patients analysed, severe TR was documented in 22.3% of patients and the mean TAPSE/PASP was 0.43 +/- 0.25. Technical success of TEER was achieved in 97.2% of participants. Severe TR vs TR <= moderate (adjusted HR 1.92, 95% CI: 1.39-2.66) and TAPSE/PASP (adjusted HR 0.45, 95% CI: 0.22-0.93) were associated with the outcome. Patients were divided according to the TAPSE/PASP ter -tile. Compared to patients with TR <= moderate, patients with severe TR had a higher event rate (TAPSE/ PASP <0.30: 32.9% vs 45.1%; 0.30 <= TAPSE/PASP <0.44: 27.8% vs 41.8%; TAPSE/PASP <0.44: 16.0% vs 40.4%), whereas the prognostic significance of TR was attenuated in patients with reduced TAPSE/PASP (i.e., RV-PA uncoupling; interaction term p=0.03). The trends were consistent in the multivariable regres-sion models, spline curves, and sensitivity analysis using post-interventional parameters. Conclusions: RV-PA coupling affects the outcome correlation of TR in patients undergoing mitral TEER. The prognostic impact of TR is attenuated in patients with RV-PA uncoupling.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sugiura, Atsushi UNSPECIFIED UNSPECIFIED UNSPECIFIED Kavsur, Refik UNSPECIFIED UNSPECIFIED UNSPECIFIED Spieker, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Tanaka, Tetsu UNSPECIFIED orcid.org/0000-0003-0780-8689 UNSPECIFIED Goto, Tadahiro UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kelm, Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Westenfeld, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Becher, Marc Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-679542
DOI:	10.4244/EIJ-D-22-00045
Journal or Publication Title:	EuroIntervention
Volume:	18
Number:	10
Page Range:	S. 852 - 869
Date:	2022
Publisher:	EUROPA EDITION
Place of Publication:	TOULOUSE CEDEX 6
ISSN:	1969-6213
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MITRAL-VALVE REPAIR Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67954