Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation
Little is known about the natural history of non-significant mitral and tricuspid regurgitation (MR and TR) following surgical aortic valve replacement (SAVR) for aortic regurgitation (AR). We retrospectively analyzed 184 patients (median age 64 (IQR, 55–74) years, 76.6% males) who underwent SAVR fo...
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MDPI AG
2023-09-01
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| author | Shirit Kazum Mordehay Vaturi Idit Yedidya Shmuel Schwartzenberg Olga Morelli Keren Skalsky Hadas Ofek Ram Sharony Ran Kornowski Yaron Shapira Alon Shechter |
| author_facet | Shirit Kazum Mordehay Vaturi Idit Yedidya Shmuel Schwartzenberg Olga Morelli Keren Skalsky Hadas Ofek Ram Sharony Ran Kornowski Yaron Shapira Alon Shechter |
| author_sort | Shirit Kazum |
| collection | DOAJ |
| description | Little is known about the natural history of non-significant mitral and tricuspid regurgitation (MR and TR) following surgical aortic valve replacement (SAVR) for aortic regurgitation (AR). We retrospectively analyzed 184 patients (median age 64 (IQR, 55–74) years, 76.6% males) who underwent SAVR for AR. Subjects with significant non-aortic valvulopathies, prior/concomitant valvular interventions, or congenital heart disease were excluded. The cohort was evaluated for MR/TR progression and, based on the latter’s occurrence, for echocardiographic and clinical indices of heart failure and mortality. By 5.8 (IQR, 2.8–11.0) years post-intervention, moderate or severe MR occurred in 20 (10.9%) patients, moderate or severe TR in 25 (13.5%), and either of the two in 36 (19.6%). Patients who developed moderate or severe MR/TR displayed greater biventricular disfunction and functional limitation and were less likely to be alive at 7.0 (IQR, 3.4–12.1) years compared to those who did not (47.2 vs. 79.7%, <i>p</i> < 0.001). The emergence of significant MR/TR was associated with preoperative atrial fibrillation/flutter, symptomatic heart failure, and above-mild MR/TR as well as concomitant composite graft use, but not with baseline echocardiographic measures of biventricular function and dimensions, aortic valve morphology, or procedural aspects. In conclusion, among patients undergoing SAVR for AR, significant MR/TR developed in one fifth by six years, correlated with more adverse course, and was anticipated by baseline clinical and echocardiographic variables. |
| first_indexed | 2024-03-10T21:42:15Z |
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| publishDate | 2023-09-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-e29980c76ecc477ba57faa3cb44e35a52023-11-19T14:36:35ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011219628010.3390/jcm12196280Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic RegurgitationShirit Kazum0Mordehay Vaturi1Idit Yedidya2Shmuel Schwartzenberg3Olga Morelli4Keren Skalsky5Hadas Ofek6Ram Sharony7Ran Kornowski8Yaron Shapira9Alon Shechter10Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelFaculty of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelDepartment of Cardiology, Rabin Medical Center, Petach Tikva 4941492, IsraelLittle is known about the natural history of non-significant mitral and tricuspid regurgitation (MR and TR) following surgical aortic valve replacement (SAVR) for aortic regurgitation (AR). We retrospectively analyzed 184 patients (median age 64 (IQR, 55–74) years, 76.6% males) who underwent SAVR for AR. Subjects with significant non-aortic valvulopathies, prior/concomitant valvular interventions, or congenital heart disease were excluded. The cohort was evaluated for MR/TR progression and, based on the latter’s occurrence, for echocardiographic and clinical indices of heart failure and mortality. By 5.8 (IQR, 2.8–11.0) years post-intervention, moderate or severe MR occurred in 20 (10.9%) patients, moderate or severe TR in 25 (13.5%), and either of the two in 36 (19.6%). Patients who developed moderate or severe MR/TR displayed greater biventricular disfunction and functional limitation and were less likely to be alive at 7.0 (IQR, 3.4–12.1) years compared to those who did not (47.2 vs. 79.7%, <i>p</i> < 0.001). The emergence of significant MR/TR was associated with preoperative atrial fibrillation/flutter, symptomatic heart failure, and above-mild MR/TR as well as concomitant composite graft use, but not with baseline echocardiographic measures of biventricular function and dimensions, aortic valve morphology, or procedural aspects. In conclusion, among patients undergoing SAVR for AR, significant MR/TR developed in one fifth by six years, correlated with more adverse course, and was anticipated by baseline clinical and echocardiographic variables.https://www.mdpi.com/2077-0383/12/19/6280mitral regurgitationtricuspid regurgitationsurgical aortic valve replacementaortic regurgitationprogression |
| spellingShingle | Shirit Kazum Mordehay Vaturi Idit Yedidya Shmuel Schwartzenberg Olga Morelli Keren Skalsky Hadas Ofek Ram Sharony Ran Kornowski Yaron Shapira Alon Shechter Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation Journal of Clinical Medicine mitral regurgitation tricuspid regurgitation surgical aortic valve replacement aortic regurgitation progression |
| title | Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation |
| title_full | Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation |
| title_fullStr | Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation |
| title_full_unstemmed | Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation |
| title_short | Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation |
| title_sort | progression of non significant mitral and tricuspid regurgitation after surgical aortic valve replacement for aortic regurgitation |
| topic | mitral regurgitation tricuspid regurgitation surgical aortic valve replacement aortic regurgitation progression |
| url | https://www.mdpi.com/2077-0383/12/19/6280 |
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