Conventional Echocardiographic Parameters or Three-dimensional Echocardiography to Evaluate Right Ventricular Function in Percutaneous Edge-to-edge Mitral Valve Repair (PMVR)

Overview

Journal Int J Cardiol Heart Vasc

Date 2019 Sep 12

PMID 31508480

Citations 3

Authors

Reinhard J Sauter

Johannes Patzelt

Matthias Mezger

Henry Nording

Jan-Christian Reil

Mohammed Saad

Peter Seizer

Juergen Schreieck

Peter Rosenberger

Harald F Langer

Harry Magunia

Affiliations

Soon will be listed here.

Abstract

Introduction: In this study, we evaluated right ventricular (RV) function before and after percutaneous mitral valve repair (PMVR) using conventional echocardiographic parameters and novel 3DE data sets acquired prior to and directly after the procedure.

Patients And Methods: Observational study on 45 patients undergoing PMVR at an university hospital.

Results: In the overall collective, the 3D RV-EF before and after PMVR showed no significant change (p = 0.16). While there was a significant increase of the fractional area change (FAC, from 23 [19-29] % to 28 [24-33] %, p = 0.001), no significant change of the tricuspid annular plane systolic excursion (TAPSE, from 17 ± 6 mm to 18 ± 5 mm (standard deviation), p = 0.33) was observed. Regarding patients with a reduced RV-EF (< 35%), a significant RV-EF improvement was observed (from 27 [23-34] % to 32.5 [30-39] % (p = 0.001). 71.4% of patients had an improved clinical outcome (improvement in 6-minute walk test and/or improvement in NYHA class of more than one grade), whereas clinical outcome did not improve in 28.6% of patients. Using univariate logistic regression analysis, the post-PMVR RV-EF (OR 1.15: 95% CI 1.02-1.29; p = 0.02) and the change in RV-EF (OR 1.13: 95% CI 1.02-1.25; p = 0.02) were significant predictors for improved clinical outcome at 6 months follow up.

Conclusion: Thus, RV function may be an important non-invasive parameter to add to the predictive parameters indicating a potential clinical benefit from treatment of severe mitral regurgitation using PMVR.

Citing Articles

Three-Dimensional Echocardiography Assessment of Right Ventricular Volumes and Function: Technological Perspective and Clinical Application.

Ahmad A, Li H, Zhang Y, Liu J, Gao Y, Qian M Diagnostics (Basel). 2022; 12(4).

PMID: 35453854 PMC: 9031180. DOI: 10.3390/diagnostics12040806.

Right Ventricular Function Improves Early After Percutaneous Mitral Valve Repair in Patients Suffering From Severe Mitral Regurgitation.

Neuser J, Buck H, Oldhafer M, Sieweke J, Bavendiek U, Bauersachs J Front Cardiovasc Med. 2022; 9:830944.

PMID: 35369337 PMC: 8968125. DOI: 10.3389/fcvm.2022.830944.

Acute changes of global and longitudinal right ventricular function: an exploratory analysis in patients undergoing open-chest mitral valve surgery, percutaneous mitral valve repair and off-pump coronary artery bypass grafting.

Keller M, Heller T, Lang T, Patzelt J, Schreieck J, Schlensak C Cardiovasc Ultrasound. 2020; 18(1):32.

PMID: 32787878 PMC: 7425536. DOI: 10.1186/s12947-020-00218-x.

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