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Influence of functional tricuspid regurgitation on right ventricular function
1Department of Surgery, Kobe University School of Medicine, Japan.
The Annals of Thoracic Surgery
|February 4, 1999
Summary
Severe functional tricuspid regurgitation (TR) can irreversibly damage right ventricular (RV) function. Preoperative RV function assessment may predict outcomes after TR repair, especially in patients with severely dilated annuli.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Right ventricular (RV) function is crucial but its response to functional tricuspid regurgitation (TR) is understudied.
- Functional TR, especially with annular dilation, may impact RV performance.
Purpose of the Study:
- To investigate the influence of functional TR on RV function in patients with left-side valvular heart disease.
- To assess the relationship between tricuspid annular diameter and RV function parameters.
Main Methods:
- 142 patients with left-side valvular heart disease and TR were grouped by tricuspid annular diameter (<40mm, 40-50mm, ≥50mm).
- Right heart parameters and RV function were assessed pre- and postoperatively (mean follow-up 102 months).
- Analysis focused on the relationship between pulmonary arteriolar resistance index and RV forward stroke work index.
Main Results:
- RV forward stroke work index increased linearly with pulmonary arteriolar resistance index in all groups.
- The slope of this relationship was less in groups with larger annular diameters, indicating impaired RV systolic function.
- Postoperative improvement was observed, but RV function remained worse in the severely dilated annulus group (group 3).
Conclusions:
- Severely dilated tricuspid annulus in functional TR can lead to irreversible RV dysfunction.
- The preoperative relationship between pulmonary arteriolar resistance index and RV forward stroke work index may predict postoperative RV function outcomes.