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Right Ventricular-Pulmonary Arterial Coupling and Afterload Reserve in Patients Undergoing Transcatheter Tricuspid Valve Repair

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Right Ventricular-Pulmonary Arterial Coupling and Afterload Reserve in Patients Undergoing Transcatheter Tricuspid Valve Repair. / Brener, Michael I; Lurz, Philipp; Hausleiter, Jörg; Rodés-Cabau, Josep; Fam, Neil; Kodali, Susheel K; Rommel, Karl-Philipp; Muntané-Carol, Guillem; Gavazzoni, Mara; Nazif, Tamim M; Pozzoli, Alberto; Alessandrini, Hannes; Latib, Azeem; Biasco, Luigi; Braun, Daniel; Brochet, Eric; Denti, Paolo; Lubos, Edith; Ludwig, Sebastian; Kalbacher, Daniel; Estevez-Loureiro, Rodrigo; Connelly, Kim A; Frerker, Christian; Ho, Edwin C; Juliard, Jean-Michel; Harr, Claudia; Monivas, Vanessa; Nickenig, Georg; Pedrazzini, Giovanni; Philippon, François; Praz, Fabien; Puri, Rishi; Schofer, Joachim; Sievert, Horst; Tang, Gilbert H L; Andreas, Martin; Thiele, Holger; Unterhuber, Matthias; Himbert, Dominique; Alcázar, Marina Ureña; Von Bardeleben, Ralph Stephan; Windecker, Stephan; Wild, Mirjam G; Maisano, Francesco; Leon, Martin B; Taramasso, Maurizio; Hahn, Rebecca T.

In: J AM COLL CARDIOL, Vol. 79, No. 5, 08.02.2022, p. 448-461.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Brener, MI, Lurz, P, Hausleiter, J, Rodés-Cabau, J, Fam, N, Kodali, SK, Rommel, K-P, Muntané-Carol, G, Gavazzoni, M, Nazif, TM, Pozzoli, A, Alessandrini, H, Latib, A, Biasco, L, Braun, D, Brochet, E, Denti, P, Lubos, E, Ludwig, S, Kalbacher, D, Estevez-Loureiro, R, Connelly, KA, Frerker, C, Ho, EC, Juliard, J-M, Harr, C, Monivas, V, Nickenig, G, Pedrazzini, G, Philippon, F, Praz, F, Puri, R, Schofer, J, Sievert, H, Tang, GHL, Andreas, M, Thiele, H, Unterhuber, M, Himbert, D, Alcázar, MU, Von Bardeleben, RS, Windecker, S, Wild, MG, Maisano, F, Leon, MB, Taramasso, M & Hahn, RT 2022, 'Right Ventricular-Pulmonary Arterial Coupling and Afterload Reserve in Patients Undergoing Transcatheter Tricuspid Valve Repair', J AM COLL CARDIOL, vol. 79, no. 5, pp. 448-461. https://doi.org/10.1016/j.jacc.2021.11.031

APA

Brener, M. I., Lurz, P., Hausleiter, J., Rodés-Cabau, J., Fam, N., Kodali, S. K., Rommel, K-P., Muntané-Carol, G., Gavazzoni, M., Nazif, T. M., Pozzoli, A., Alessandrini, H., Latib, A., Biasco, L., Braun, D., Brochet, E., Denti, P., Lubos, E., Ludwig, S., ... Hahn, R. T. (2022). Right Ventricular-Pulmonary Arterial Coupling and Afterload Reserve in Patients Undergoing Transcatheter Tricuspid Valve Repair. J AM COLL CARDIOL, 79(5), 448-461. https://doi.org/10.1016/j.jacc.2021.11.031

Vancouver

Brener MI, Lurz P, Hausleiter J, Rodés-Cabau J, Fam N, Kodali SK et al. Right Ventricular-Pulmonary Arterial Coupling and Afterload Reserve in Patients Undergoing Transcatheter Tricuspid Valve Repair. J AM COLL CARDIOL. 2022 Feb 8;79(5):448-461. https://doi.org/10.1016/j.jacc.2021.11.031

Bibtex

@article{7616ab5001bf470e90c53209b245ac2d,
title = "Right Ventricular-Pulmonary Arterial Coupling and Afterload Reserve in Patients Undergoing Transcatheter Tricuspid Valve Repair",
abstract = "BACKGROUND: The right ventricular (RV)-pulmonary arterial (PA) coupling ratio relates the efficiency with which RV stroke work is transferred into the PA. Lower ratios indicate an inadequate RV contractile response to increased afterload.OBJECTIVES: This study sought to evaluate the prognostic significance of RV-PA coupling in patients with tricuspid regurgitation (TR) who were undergoing transcatheter tricuspid valve repair or replacement (TTVR).METHODS: The study investigators calculated RV-PA coupling ratios for patients enrolled in the global TriValve registry by dividing the tricuspid annular plane systolic excursion (TAPSE) by the PA systolic pressure (PASP) from transthoracic echocardiograms performed before the procedure and 30 days after the procedure. The primary endpoint was all-cause mortality at 1-year follow-up.RESULTS: Among 444 patients analyzed, their mean age was 76.9 ± 9.1 years, and 53.8% of the patients were female. The median TAPSE/PASP ratio was 0.406 mm/mm Hg (interquartile range: 0.308-0.567 mm/mm Hg). Sixty-three patients died within 1 year of TTVR, 21 with a TAPSE/PASP ratio >0.406 and 42 with a TAPSE/PASP ratio ≤0.406. In multivariable Cox regression analysis, a TAPSE/PASP ratio >0.406 vs ≤0.406 was associated with a decreased risk of all-cause mortality (HR: 0.57; 95% CI: 0.35-0.93; P = 0.023). In 234 (52.7%) patients with echocardiograms 30 days after TTVR, a decline in RV-PA coupling was independently associated with reduced odds of all-cause mortality (odds ratio [OR]: 0.42; 95% CI: 0.19-0.93; P = 0.032). The magnitude of TR reduction after TTVR (≥1+ vs <1+; OR: 2.53; 95% CI: 1.06-6.03; P = 0.037) was independently associated with a reduction in post-TTVR RV-PA coupling.CONCLUSIONS: RV-PA coupling is a powerful, independent predictor of all-cause mortality in patients with TR undergoing TTVR. These data suggest that the TAPSE/PASP ratio can inform patient selection and prognostication following TTVR.",
keywords = "Aged, Cardiac Surgical Procedures/methods, Echocardiography, Doppler, Female, Follow-Up Studies, Humans, Male, Postoperative Period, Pulmonary Artery/physiopathology, Pulmonary Wedge Pressure/physiology, Registries, Retrospective Studies, Stroke Volume/physiology, Tricuspid Valve/diagnostic imaging, Tricuspid Valve Insufficiency/physiopathology, Ventricular Function, Left, Ventricular Function, Right/physiology",
author = "Brener, {Michael I} and Philipp Lurz and J{\"o}rg Hausleiter and Josep Rod{\'e}s-Cabau and Neil Fam and Kodali, {Susheel K} and Karl-Philipp Rommel and Guillem Muntan{\'e}-Carol and Mara Gavazzoni and Nazif, {Tamim M} and Alberto Pozzoli and Hannes Alessandrini and Azeem Latib and Luigi Biasco and Daniel Braun and Eric Brochet and Paolo Denti and Edith Lubos and Sebastian Ludwig and Daniel Kalbacher and Rodrigo Estevez-Loureiro and Connelly, {Kim A} and Christian Frerker and Ho, {Edwin C} and Jean-Michel Juliard and Claudia Harr and Vanessa Monivas and Georg Nickenig and Giovanni Pedrazzini and Fran{\c c}ois Philippon and Fabien Praz and Rishi Puri and Joachim Schofer and Horst Sievert and Tang, {Gilbert H L} and Martin Andreas and Holger Thiele and Matthias Unterhuber and Dominique Himbert and Alc{\'a}zar, {Marina Ure{\~n}a} and {Von Bardeleben}, {Ralph Stephan} and Stephan Windecker and Wild, {Mirjam G} and Francesco Maisano and Leon, {Martin B} and Maurizio Taramasso and Hahn, {Rebecca T}",
note = "Copyright {\textcopyright} 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2022",
month = feb,
day = "8",
doi = "10.1016/j.jacc.2021.11.031",
language = "English",
volume = "79",
pages = "448--461",
journal = "J AM COLL CARDIOL",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "5",

}

RIS

TY - JOUR

T1 - Right Ventricular-Pulmonary Arterial Coupling and Afterload Reserve in Patients Undergoing Transcatheter Tricuspid Valve Repair

AU - Brener, Michael I

AU - Lurz, Philipp

AU - Hausleiter, Jörg

AU - Rodés-Cabau, Josep

AU - Fam, Neil

AU - Kodali, Susheel K

AU - Rommel, Karl-Philipp

AU - Muntané-Carol, Guillem

AU - Gavazzoni, Mara

AU - Nazif, Tamim M

AU - Pozzoli, Alberto

AU - Alessandrini, Hannes

AU - Latib, Azeem

AU - Biasco, Luigi

AU - Braun, Daniel

AU - Brochet, Eric

AU - Denti, Paolo

AU - Lubos, Edith

AU - Ludwig, Sebastian

AU - Kalbacher, Daniel

AU - Estevez-Loureiro, Rodrigo

AU - Connelly, Kim A

AU - Frerker, Christian

AU - Ho, Edwin C

AU - Juliard, Jean-Michel

AU - Harr, Claudia

AU - Monivas, Vanessa

AU - Nickenig, Georg

AU - Pedrazzini, Giovanni

AU - Philippon, François

AU - Praz, Fabien

AU - Puri, Rishi

AU - Schofer, Joachim

AU - Sievert, Horst

AU - Tang, Gilbert H L

AU - Andreas, Martin

AU - Thiele, Holger

AU - Unterhuber, Matthias

AU - Himbert, Dominique

AU - Alcázar, Marina Ureña

AU - Von Bardeleben, Ralph Stephan

AU - Windecker, Stephan

AU - Wild, Mirjam G

AU - Maisano, Francesco

AU - Leon, Martin B

AU - Taramasso, Maurizio

AU - Hahn, Rebecca T

N1 - Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2022/2/8

Y1 - 2022/2/8

N2 - BACKGROUND: The right ventricular (RV)-pulmonary arterial (PA) coupling ratio relates the efficiency with which RV stroke work is transferred into the PA. Lower ratios indicate an inadequate RV contractile response to increased afterload.OBJECTIVES: This study sought to evaluate the prognostic significance of RV-PA coupling in patients with tricuspid regurgitation (TR) who were undergoing transcatheter tricuspid valve repair or replacement (TTVR).METHODS: The study investigators calculated RV-PA coupling ratios for patients enrolled in the global TriValve registry by dividing the tricuspid annular plane systolic excursion (TAPSE) by the PA systolic pressure (PASP) from transthoracic echocardiograms performed before the procedure and 30 days after the procedure. The primary endpoint was all-cause mortality at 1-year follow-up.RESULTS: Among 444 patients analyzed, their mean age was 76.9 ± 9.1 years, and 53.8% of the patients were female. The median TAPSE/PASP ratio was 0.406 mm/mm Hg (interquartile range: 0.308-0.567 mm/mm Hg). Sixty-three patients died within 1 year of TTVR, 21 with a TAPSE/PASP ratio >0.406 and 42 with a TAPSE/PASP ratio ≤0.406. In multivariable Cox regression analysis, a TAPSE/PASP ratio >0.406 vs ≤0.406 was associated with a decreased risk of all-cause mortality (HR: 0.57; 95% CI: 0.35-0.93; P = 0.023). In 234 (52.7%) patients with echocardiograms 30 days after TTVR, a decline in RV-PA coupling was independently associated with reduced odds of all-cause mortality (odds ratio [OR]: 0.42; 95% CI: 0.19-0.93; P = 0.032). The magnitude of TR reduction after TTVR (≥1+ vs <1+; OR: 2.53; 95% CI: 1.06-6.03; P = 0.037) was independently associated with a reduction in post-TTVR RV-PA coupling.CONCLUSIONS: RV-PA coupling is a powerful, independent predictor of all-cause mortality in patients with TR undergoing TTVR. These data suggest that the TAPSE/PASP ratio can inform patient selection and prognostication following TTVR.

AB - BACKGROUND: The right ventricular (RV)-pulmonary arterial (PA) coupling ratio relates the efficiency with which RV stroke work is transferred into the PA. Lower ratios indicate an inadequate RV contractile response to increased afterload.OBJECTIVES: This study sought to evaluate the prognostic significance of RV-PA coupling in patients with tricuspid regurgitation (TR) who were undergoing transcatheter tricuspid valve repair or replacement (TTVR).METHODS: The study investigators calculated RV-PA coupling ratios for patients enrolled in the global TriValve registry by dividing the tricuspid annular plane systolic excursion (TAPSE) by the PA systolic pressure (PASP) from transthoracic echocardiograms performed before the procedure and 30 days after the procedure. The primary endpoint was all-cause mortality at 1-year follow-up.RESULTS: Among 444 patients analyzed, their mean age was 76.9 ± 9.1 years, and 53.8% of the patients were female. The median TAPSE/PASP ratio was 0.406 mm/mm Hg (interquartile range: 0.308-0.567 mm/mm Hg). Sixty-three patients died within 1 year of TTVR, 21 with a TAPSE/PASP ratio >0.406 and 42 with a TAPSE/PASP ratio ≤0.406. In multivariable Cox regression analysis, a TAPSE/PASP ratio >0.406 vs ≤0.406 was associated with a decreased risk of all-cause mortality (HR: 0.57; 95% CI: 0.35-0.93; P = 0.023). In 234 (52.7%) patients with echocardiograms 30 days after TTVR, a decline in RV-PA coupling was independently associated with reduced odds of all-cause mortality (odds ratio [OR]: 0.42; 95% CI: 0.19-0.93; P = 0.032). The magnitude of TR reduction after TTVR (≥1+ vs <1+; OR: 2.53; 95% CI: 1.06-6.03; P = 0.037) was independently associated with a reduction in post-TTVR RV-PA coupling.CONCLUSIONS: RV-PA coupling is a powerful, independent predictor of all-cause mortality in patients with TR undergoing TTVR. These data suggest that the TAPSE/PASP ratio can inform patient selection and prognostication following TTVR.

KW - Aged

KW - Cardiac Surgical Procedures/methods

KW - Echocardiography, Doppler

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Postoperative Period

KW - Pulmonary Artery/physiopathology

KW - Pulmonary Wedge Pressure/physiology

KW - Registries

KW - Retrospective Studies

KW - Stroke Volume/physiology

KW - Tricuspid Valve/diagnostic imaging

KW - Tricuspid Valve Insufficiency/physiopathology

KW - Ventricular Function, Left

KW - Ventricular Function, Right/physiology

U2 - 10.1016/j.jacc.2021.11.031

DO - 10.1016/j.jacc.2021.11.031

M3 - SCORING: Journal article

C2 - 35115101

VL - 79

SP - 448

EP - 461

JO - J AM COLL CARDIOL

JF - J AM COLL CARDIOL

SN - 0735-1097

IS - 5

ER -