The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant  

作　　者：Kevin M.Veen Grigorios Papageorgiou Casper F.Zijderhand Mostafa M.Mokhles Jasper J.Brugts Olivier C.Manintveld Alina A.Constantinescu Jos A.Bekkers Johanna J.Makkenberg Ad J.J.CBogers Kadir Caliskan 

机构地区：[1]Department of Cardiothoracic Surgery,Erasmus MC,3000 CA Rotterdam,The Netherlands [2]Department of Biostatistics,Erasmus MC,3000 CA Rotterdam,The Netherlands [3]Department of Cardiology,Erasmus MC,3000 CA Rotterdam,The Netherlands

出　　处：《Frontiers of Medicine》2023年第3期527-533,共7页医学前沿（英文版）

摘　　要：In this study,we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation(TR),taking into account its dynamic nature,after biatrial orthotopic heart transplant(OHT).All consecutive adult patients undergoing biatrial OHT(1984−2017)with an available follow-up echocardiogram were included.Mixed-models were used to model the evolution of TR.The mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with mortality.In total,572 patients were included(median age:50 years,males:74.9%).Approximately 32% of patients had moderate-to-severe TR immediately after surgery.However,this declined to 11%on 5 years and 9% on 10 years after surgery,adjusted for survival bias.Preimplant mechanical support was associated with less TR during follow-up,whereas concurrent LV dysfunction was significantly associated with more TR during follow-up.Survival at 1,5,10,20 years was 97%±1%,88%±1%,66%±2% and 23%±2%,respectively.The presence of moderate-to-severe TR during follow-up was associated with higher mortality(HR:1.07,95%CI(1.02–1.12),p=0.006).The course of TR was positively correlated with the course of creatinine(R=0.45).TR during follow-up is significantly associated with higher mortality and worse renal function.Nevertheless,probability of TR is the highest immediately after OHT and decreases thereafter.Therefore,it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.

关 键 词：orthotopic heart transplant tricuspid regurgitation clinical impact biatrial heart transplantation 

分 类 号：R654.2[医药卫生—外科学]