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心脏植入式电子设备(CIED)植入术后的三尖瓣反流(TR)——对有或无左心室功能障碍患者的一年观察

Tricuspid Regurgitation (TR) after Implantation of a Cardiac Implantable Electronic Device (CIED)-One-Year Observation of Patients with or without Left Ventricular Dysfunction.

作者信息

Chodór-Rozwadowska Karolina, Sawicka Magdalena, Morawski Stanisław, Kalarus Zbigniew, Kukulski Tomasz

机构信息

Doctoral School, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.

Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, 40-055 Katowice, Poland.

出版信息

J Cardiovasc Dev Dis. 2023 Aug 19;10(8):353. doi: 10.3390/jcdd10080353.

Abstract

The frequency of tricuspid regurgitation (TR) progression after cardiac implantable electronic devices (CIEDs) implantation varies from 7.2% to 44.7%. TR is associated with increased mortality and hospitalizations due to heart failure (HF) decompensation. The aim of this study was to assess the rate of early TR progression after CIED implantation and the frequency of HF decompensation and mortality. The 101 patients, who received a CIED between March 2020 and October 2021, before the procedure were divided into two groups-one with left ventricle ejection fraction (LVEF) ≥ 40% ( = 60) and one with LVEF < 40% ( = 41). Lead-related tricuspid regurgitation (LRTR) was defined as an increase of TR by at least one grade. The follow-up period was similar between both groups and was on average 13 (12-16) months. In the whole study group, TR progression by one grade was 34.6% and by two or more grades 15.8%. The significant changes in the dynamic of TR degree were as follows before and after implantation: none/trivial TR in group 1 (61.7% vs. 28.3%, = 0.01) and severe/massive TR in group 2 (0.0% vs. 14.6%, = 0.03). The groups did not differ from each other in terms of survival from decompensation of HF (18.3% vs. 36.6%, = 0.70) and survival from death (1.7% vs. 4.9%, = 0.16). At the one-year follow-up, the baseline LVEF did not affect the survival rate from death or HF decompensation among patients with a progression of TR after CIED implantation. In this study, a progression by one grade was more common in group 1, but the occurrence of severe/massive TR after implantation was more specific for group 2.

摘要

心脏植入式电子设备(CIED)植入术后三尖瓣反流(TR)进展的发生率在7.2%至44.7%之间。TR与因心力衰竭(HF)失代偿导致的死亡率增加和住院率增加相关。本研究的目的是评估CIED植入术后早期TR进展的发生率以及HF失代偿和死亡率。2020年3月至2021年10月期间接受CIED的101例患者,在手术前被分为两组,一组左心室射血分数(LVEF)≥40%(n = 60),另一组LVEF < 40%(n = 41)。导线相关三尖瓣反流(LRTR)定义为TR至少升高一级。两组的随访期相似,平均为13(12 - 16)个月。在整个研究组中,TR进展一级的比例为34.6%,进展两级或更多级的比例为15.8%。植入前后TR程度动态的显著变化如下:第一组中无/微量TR(61.7%对28.3%,P = 0.01),第二组中重度/大量TR(0.0%对14.6%,P = 0.03)。两组在HF失代偿后的生存率(18.3%对36.6%,P = 0.70)和死亡后的生存率(1.7%对4.9%,P = 0.16)方面没有差异。在一年随访时,基线LVEF不影响CIED植入术后TR进展患者的死亡率或HF失代偿生存率。在本研究中,第一组中进展一级更为常见,但植入后重度/大量TR的发生在第二组中更具特异性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecba/10455858/5af071dc6f46/jcdd-10-00353-g001.jpg

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