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三尖瓣反流与心力衰竭:经皮治疗时代治疗组与未治疗组的转归

Tricuspid regurgitation and heart failure: the fate of treated vs. untreated cohort in the percutaneous era.

作者信息

Zancanaro Edoardo, Romeo Maria Rita, Nardone Annalisa, D'Agostino Andreina, Mariani Massimiliano, Berti Sergio

机构信息

Cardiac Surgery Department, Heart Valve Center, San Raffaele University Hospital, Via Olgettina 69, 20140 Milan, Italy.

Fondazione Toscana G. Monasterio, Ospedale del Cuore G. Pasquinucci, Massa, Italy.

出版信息

Eur Heart J Imaging Methods Pract. 2024 Aug 5;2(2):qyae080. doi: 10.1093/ehjimp/qyae080. eCollection 2024 Apr.

Abstract

AIMS

Tricuspid regurgitation (TR) is associated with heart failure (HF) and reduced survival. Within a short-time period, transcatheter tricuspid valve repair or replacement (TTVR/TTVr) for TR has evolved from innovation to clinical reality. The present study's aim is to provide 1-year results between TR patients treated with TTVR and TTVr compared with untreated patients, in terms of cardiac survival, rehospitalization, right-side HF symptom development, and New York Heart Association (NYHA) improvement.

METHODS AND RESULTS

Seventy-seven patients (pts) have been prospectively inserted into a dedicated database from January 2020 till January 2023. Twenty-six patients (33.8%) have been treated with TTVR/r [treated group (TG)], and 51 pts (66.2%) have been left untreated with medical therapy optimization [untreated group (UNTG)]. Analysing the cardiac death between the two groups, there was a significant statistical difference since TG has less incidence of exitus in the general population ( = 0.05). Concerning HF hospitalization, TG has a lower incidence with a = 0.005. In TG, there was a significant improvement in NYHA class at follow-up (FUP) ( = 0.001) as well as an improvement in right-side HF symptoms ( = 0.001).

CONCLUSION

This study shows that treatment in the case of TR with right-side HF has a positive impact on cardiac death and HF hospitalization at 1 year. And there is a significant improvement in clinical and echocardiographic status at FUP in the TG.

摘要

目的

三尖瓣反流(TR)与心力衰竭(HF)及生存率降低相关。在短时间内,经导管三尖瓣修复或置换术(TTVR/TTVr)治疗TR已从创新变为临床现实。本研究的目的是比较接受TTVR和TTVr治疗的TR患者与未治疗患者在心脏生存率、再次住院、右侧HF症状发展及纽约心脏协会(NYHA)心功能改善方面的1年结果。

方法与结果

2020年1月至2023年1月期间,77例患者被前瞻性纳入一个专用数据库。26例患者(33.8%)接受了TTVR/r治疗[治疗组(TG)],51例患者(66.2%)未接受优化药物治疗而未治疗[未治疗组(UNTG)]。分析两组之间的心脏死亡情况,存在显著统计学差异,因为TG在总体人群中的死亡发生率较低(P = 0.05)。关于HF住院情况,TG的发生率较低(P = 0.005)。在TG中,随访(FUP)时NYHA分级有显著改善(P = 0.001),右侧HF症状也有改善(P = 0.001)。

结论

本研究表明,TR伴右侧HF患者接受治疗对1年时的心脏死亡和HF住院有积极影响。TG在FUP时的临床和超声心动图状况有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d72/11367954/a7b6c5c7c4cf/qyae080_ga.jpg

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