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Cardiac Remodeling After Transcatheter Tricuspid Valve Replacement: Insights From Multimodality Imaging
Robin Le Ruz1, Vratika Agarwal2, Isaac George2
1Nantes Université, CHU Nantes, Interventional Cardiology Department, l'institut du thorax, F-44000, Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, F-44000, Nantes, France; Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Transcatheter tricuspid valve replacement (TTVR) significantly improves right ventricular (RV) function and reduces RV size. Left ventricular (LV) remodeling also occurs, with increased LV volume and reduced eccentricity, particularly benefiting patients with baseline higher LV eccentricity.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Cardiac Imaging
Background:
- Limited research exists on ventricular remodeling after transcatheter tricuspid valve replacement (TTVR).
- Tricuspid regurgitation significantly impacts right ventricular (RV) function and structure.
Purpose of the Study:
- To investigate biventricular structural and functional changes following TTVR.
- To assess the impact of TTVR on RV and left ventricular (LV) remodeling.
Main Methods:
- Retrospective single-center study of patients undergoing TTVR.
- Evaluation of ventricular remodeling using transthoracic echocardiography and cardiac computed tomography (CT).
- CT analysis included RV ejection fraction (RVEF), effective RVEF, RV coupling, septal curvature, and LV eccentricity index (aEI).
Main Results:
- TTVR effectively reduced tricuspid regurgitation, improving RV function measures.
- Significant increases in effective RVEF and RV coupling were observed post-TTVR.
- RV end-diastolic volume (RVEDV) decreased, while LV end-diastolic volume (LVEDV) increased, with reduced LV eccentricity.
Conclusions:
- TTVR promotes favorable biventricular remodeling, characterized by reduced RVEDV and increased LVEDV.
- Improved RV function and coupling, alongside reduced LV eccentricity, are key outcomes post-TTVR.
- Patients with higher baseline LV eccentricity may experience greater clinical benefits from TTVR.
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