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Moderate/severe tricuspid regurgitation predicts survival after PMVR

22 Oct 2019

Moderate or severe tricuspid regurgitation (TR) after percutaneous mitral valve repair (PMVR) is associated with worse clinical outcomes and long-term survival, a recent study has found.

Researchers performed a retrospective observational investigation of 213 consecutive PMVR patients, who were divided into two groups according to the degree of TR: none/mild (n=129; mean age, 75.3±8.9 years; 71.3 percent male) and moderate/severe (n=84; mean age, 75.8±8.9 years; 60.7 percent male). Those in the latter group had worse functional capacity after the procedure.

The overall survival rates at 1 and 2 years after PMVR were 79.3 percent (n=169) and 63.4 percent (n=135), respectively. These figures were significantly higher in the no/mild vs moderate/severe TR groups (1 year: 85.3 percent vs 70.2 percent; p=0.011; 2 years: 68.2 percent vs 56.0 percent; p=0.025). The median survival time was 1,458 days.

Fully adjusted proportional hazards models confirmed that postprocedural TR grade was a significant and independent predictor of long-term survival (hazard ratio [HR], 2.055, 95 percent CI, 1.317–3.206; p=0.002).

Other predictive factors included a severely impaired postprocedural left ventricular systolic function (HR, 3.145, 1.199–8.250; p=0.020) and chronic kidney disease, defined either as estimated glomerular filtration rate 30–60 (HR, 1.917, 1.109–3.314; p=0.02) or <30 mL/min (HR, 3.969, 1.981–7.951; p<0.001)

“TR should be taken into account when patients undergo PMVR, including right ventricular characteristics and pulmonary pressure,” said researchers. “A closer monitoring and follow-up in patients with residual moderate to severe TR seems reasonable.”

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