Guler Arda, Kahveci Gokhan, Tanboga Ibrahim Halil, Erata Yunus Emre, Arslan Enes, Tukenmez Karakurt Seda, Iyigun Taner, Aydin Unal, Onan Burak, Sanioglu Soner, Kalkan Ali Kemal, Babur Guler Gamze
Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Liv Hospital, Istinye University, Istanbul, Turkey.
Int J Cardiovasc Imaging. 2023 Oct;39(10):1897-1908. doi: 10.1007/s10554-023-02923-w. Epub 2023 Aug 2.
Right ventricular (RV) function is a determining factor for clinical outcomes in patients undergoing tricuspid valve surgery (TVS). Our aim was to investigate the importance of the function of the right ventricular outflow tract (RVOT), which is an important anatomical region of the RV, in patients underwent TVS. 104 patients who underwent TVS were analyzed retrospectively. Patients with previous cardiac surgery, congenital heart disease, or heart failure were excluded. The parasternal short-axis view at the level of the aortic root was used to measure RVOT dimensions and RVOT fractional shortening (RVOT-FS). The effect of RVOT diameter and function on major adverse cardiac events (MACE) after TVS was investigated. In our study, MACE, consisting of pacemaker implantation, acute kidney injury, postoperative atrial fibrillation and mortality, was developed at 44 (42.3%) patients.We compared the predictive performances of RVOT end-systolic (RVOTs) diameter, RVOT end-diastolic (RVOTd) diameter, RVOT-FS and RV diameters in prediction of MACE. The model including the RVOTs had higher AUC, R2 and likelihood ratio X2 values (0.775, 0.287 and 25.0, respectively) than RVOTd (0.770, 0.279 and 24.2, respectively) and RVOT-FS (0.750, 0.215 and 18.1, respectively). RVOT diameters showed better performance in predicting MACE than RV diameters. Moreover, there was statistically significant association between RVOTs, RVOTd and MACE (p value were 0.014 and 0.027, respectively), while no association between RVOT-FS and MACE (p value was 0.177). In summary, we determined that the RVOT diameters are important predictors for the in-hospital clinical outcomes of patients who underwent TVS.
右心室（RV）功能是接受三尖瓣手术（TVS）患者临床结局的决定因素。我们的目的是研究右心室流出道（RVOT）功能在接受TVS患者中的重要性，RVOT是右心室的一个重要解剖区域。对104例接受TVS的患者进行回顾性分析。排除既往有心脏手术、先天性心脏病或心力衰竭的患者。采用主动脉根部水平的胸骨旁短轴视图测量RVOT尺寸和RVOT缩短分数（RVOT-FS）。研究RVOT直径和功能对TVS后主要不良心脏事件（MACE）的影响。在我们的研究中，44例（42.3%）患者发生了MACE，包括起搏器植入、急性肾损伤、术后房颤和死亡。我们比较了RVOT收缩末期（RVOTs）直径、RVOT舒张末期（RVOTd）直径、RVOT-FS和RV直径对MACE的预测性能。包含RVOTs的模型的AUC、R2和似然比X2值（分别为0.775、0.287和25.0）高于RVOTd（分别为0.770、0.279和24.2）和RVOT-FS（分别为0.750、0.215和18.1）。RVOT直径在预测MACE方面比RV直径表现更好。此外，RVOTs、RVOTd与MACE之间存在统计学显著关联（p值分别为0.014和0.027），而RVOT-FS与MACE之间无关联（p值为0.177）。总之，我们确定RVOT直径是接受TVS患者院内临床结局的重要预测指标。
