Literature DB >> 32598993

Pulmonary capillary wedge pressure (PCWP) as prognostic indicator in patients undergoing transcatheter valve repair (TTVR) of severe tricuspid regurgitation.

Refik Kavsur1, Hannah Hupp1, Atsushi Sugiura1, Can Öztürk1, Marcel Weber1, Georg Nickenig1, Vedat Tiyerili1, Marc Ulrich Becher2.   

Abstract

BACKGROUND: TTVR represents a minimal invasive alternative for patients with tricuspid regurgitation (TR). PCWP is a haemodynamic parameter indicating pulmonary hypertension due to left-sided heart failure.
METHODS: We evaluated pulmonary capillary wedge pressure (PCWP) as prognostic outcome parameter in patients undergoing transcatheter tricuspid valve repair (TTVR). A total of 60 patients who underwent right heart catheterization prior to TTVR were included. Patient population was categorized into a low and high PCWP group according to the median PCWP of 16 mmHg.
RESULTS: TTVR included transcatheter tricuspid annuloplasty (13 patients) and edge-to-edge repair [37 patients for isolated TR; 10 patients for combined TR and mitral regurgitation]. Kaplan-Meier analysis and log-rank test revealed reduced 6-months event-free survival for patients with high PCWP (>16 mmHg) in comparison to those with low PCWP (≤16 mmHg) (p = 0.009). High PCWP was associated with increased occurrence of the composite endpoint of death and cardiac readmission (HR 4.67, 1.32-16.55). Moreover, adjusted with other predictive variables within the univariate analysis (left ventricular ejection fraction, history of smoking, tricuspid annular plane systolic excursion), PCWP remained an endpoint predictor (HR 1.11, 1.003-1.24). Best predicting value was evaluated for the cut-off >16 mmHg (AUC 0.700, 0.552-0.848). Patients with a high PCWP tended to have less TR recurrence (p = 0,059) and lower NYHA class (p = 0.062) after one month of follow-up.
CONCLUSION: Here we demonstrate that PCWP is a predictive outcome parameter in TTVR patients. Patients with a PCWP ≤16 mmHg had a favourable outcome with lower mortality and morbidity gaining more benefit of TTVR.
Copyright © 2020 Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Pulmonary capillary wedge pressure; Right heart catheterization; Transcatheter tricuspid valve repair; Tricuspid regurgitation; Tricuspid valve

Mesh:

Year:  2020        PMID: 32598993     DOI: 10.1016/j.ijcard.2020.06.031

Source DB:  PubMed          Journal:  Int J Cardiol        ISSN: 0167-5273            Impact factor:   4.164


  2 in total

1.  Prognostic impact of hepatorenal function in patients undergoing transcatheter tricuspid valve repair.

Authors:  Tetsu Tanaka; Refik Kavsur; Atsushi Sugiura; Johanna Vogelhuber; Can Öztürk; Marcel Weber; Vedat Tiyerili; Sebastian Zimmer; Georg Nickenig; Marc Ulrich Becher
Journal:  Sci Rep       Date:  2021-07-13       Impact factor: 4.379

2.  Prognostic significance of the get with the guidelines-heart failure (GWTG-HF) risk score in patients undergoing trans-catheter tricuspid valve repair (TTVR).

Authors:  Refik Kavsur; Hannah Emmi Hupp-Herschel; Atsushi Sugiura; Tetsu Tanaka; Can Öztürk; Marcel Weber; Georg Nickenig; Vedat Tiyerili; Marc Ulrich Becher
Journal:  Heart Vessels       Date:  2021-05-22       Impact factor: 2.037

  2 in total

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