Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery
Introduction Isolated tricuspid valve surgery (TVS) may be associated with high morbidity and mortality. The aim of this study was to investigate the association of preoperative imaging and haemodynamic data derived from echocardiography (ECHO), cardiac magnetic resonance (CMR) and right heart cathe...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-08-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/9/2/e002124.full |
| _version_ | 1797780956237529088 |
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| author | Serge C Harb Brian Griffin Scott D Flamm Paul C Cremer Shinya Unai Gosta Pettersson Amgad Mentias Mazen Hanna Essa Hariri Nicholas Kassis Habib Layoun Remy Daou Ossama Abou Hassan Jonathan Hansen Joseph Kassab Haytham Elgharably |
| author_facet | Serge C Harb Brian Griffin Scott D Flamm Paul C Cremer Shinya Unai Gosta Pettersson Amgad Mentias Mazen Hanna Essa Hariri Nicholas Kassis Habib Layoun Remy Daou Ossama Abou Hassan Jonathan Hansen Joseph Kassab Haytham Elgharably |
| author_sort | Serge C Harb |
| collection | DOAJ |
| description | Introduction Isolated tricuspid valve surgery (TVS) may be associated with high morbidity and mortality. The aim of this study was to investigate the association of preoperative imaging and haemodynamic data derived from echocardiography (ECHO), cardiac magnetic resonance (CMR) and right heart catheterisation (RHC) with postoperative outcomes following TVS.Methods In a retrospective cohort study, patients who underwent isolated TVS at our institution between 2012 and 2020 were screened and followed up to 1 year. We only included those who had all three tests before surgery: ECHO, CMR and RHC. Patients with congenital heart disease, infective endocarditis and those who underwent concomitant valve or pericardial surgery were excluded. The primary outcome was a composite of mortality and congestive heart failure at 1 year. Time-to-event analyses at 1 year and Cox proportional hazards regression analyses were performed.Results A total of 60 patients were included (mean age of 60±14 years, 63% women), of whom 67% underwent TV repair. The primary outcome occurred in 16 patients (27%) with a 1-year mortality of 7%. It was associated with ECHO-derived right ventricular (RV) free wall strain and RHC-derived RV systolic and diastolic as well as mean pulmonary pressures. On multivariable Cox regression analysis, only RV systolic and diastolic pressures were significantly associated with the primary outcome at 1 year (HRs=5.9 and 3.4, respectively, p<0.05).Conclusion Baseline invasive haemodynamic assessment could have a strong association with clinical outcomes and help risk-stratify patients undergoing isolated TVS. |
| first_indexed | 2024-03-12T23:51:06Z |
| format | Article |
| id | doaj.art-410af6c931fc4ffcbb40d009c0ceec02 |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-03-12T23:51:06Z |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-410af6c931fc4ffcbb40d009c0ceec022023-07-13T13:00:07ZengBMJ Publishing GroupOpen Heart2053-36242022-08-019210.1136/openhrt-2022-002124Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgerySerge C Harb0Brian Griffin1Scott D Flamm2Paul C Cremer3Shinya Unai4Gosta Pettersson5Amgad Mentias6Mazen Hanna7Essa Hariri8Nicholas Kassis9Habib Layoun10Remy Daou11Ossama Abou Hassan12Jonathan Hansen13Joseph Kassab14Haytham Elgharably15Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USAImaging Institute, Cleveland Clinic, Cleveland, Ohio, USA5 Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USAThoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, USADepartment of Cardiothoracic Surgery, Cleveland Clinic, Cleveland, Ohio, USA4 Department of Medicine, Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA2Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USADepartment of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA1 Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA2 Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USAFamily Medicine, Hotel-Dieu De France, Achrafieh, LebanonHeart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USAHeart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USAHeart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USAHeart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USAIntroduction Isolated tricuspid valve surgery (TVS) may be associated with high morbidity and mortality. The aim of this study was to investigate the association of preoperative imaging and haemodynamic data derived from echocardiography (ECHO), cardiac magnetic resonance (CMR) and right heart catheterisation (RHC) with postoperative outcomes following TVS.Methods In a retrospective cohort study, patients who underwent isolated TVS at our institution between 2012 and 2020 were screened and followed up to 1 year. We only included those who had all three tests before surgery: ECHO, CMR and RHC. Patients with congenital heart disease, infective endocarditis and those who underwent concomitant valve or pericardial surgery were excluded. The primary outcome was a composite of mortality and congestive heart failure at 1 year. Time-to-event analyses at 1 year and Cox proportional hazards regression analyses were performed.Results A total of 60 patients were included (mean age of 60±14 years, 63% women), of whom 67% underwent TV repair. The primary outcome occurred in 16 patients (27%) with a 1-year mortality of 7%. It was associated with ECHO-derived right ventricular (RV) free wall strain and RHC-derived RV systolic and diastolic as well as mean pulmonary pressures. On multivariable Cox regression analysis, only RV systolic and diastolic pressures were significantly associated with the primary outcome at 1 year (HRs=5.9 and 3.4, respectively, p<0.05).Conclusion Baseline invasive haemodynamic assessment could have a strong association with clinical outcomes and help risk-stratify patients undergoing isolated TVS.https://openheart.bmj.com/content/9/2/e002124.full |
| spellingShingle | Serge C Harb Brian Griffin Scott D Flamm Paul C Cremer Shinya Unai Gosta Pettersson Amgad Mentias Mazen Hanna Essa Hariri Nicholas Kassis Habib Layoun Remy Daou Ossama Abou Hassan Jonathan Hansen Joseph Kassab Haytham Elgharably Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery Open Heart |
| title | Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery |
| title_full | Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery |
| title_fullStr | Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery |
| title_full_unstemmed | Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery |
| title_short | Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery |
| title_sort | imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery |
| url | https://openheart.bmj.com/content/9/2/e002124.full |
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