TY - JOUR
T1 - Prevalence of significant tricuspid regurgitation in patients with successful percutaneous mitral valvuloplasty for mitral stenosis
T2 - Results from 12 years' follow-up of one centre prospective registry
AU - Lee, Seung Pyo
AU - Kim, Hyung Kwan
AU - Kim, Kyung Hee
AU - Kim, Ji Hyun
AU - Park, Hyo Eun
AU - Kim, Yong Jin
AU - Cho, Goo Yeong
AU - Sohn, Dae Won
PY - 2013/1
Y1 - 2013/1
N2 - Background: Percutaneous mitral valvuloplasty (PMV) is an attractive therapeutic option for mitral stenosis (MS). Objective: To investigate the incidence and development of tricuspid regurgitation (TR) long after successful PMV. Design, patients and interventions: A prospective cohort of 299 patients with symptomatic MS who underwent successful PMV as first-line treatment between 1988 and 2010. Setting: One tertiary university hospital. Main outcome measures: Significant TR, defined as a grade ≥3 on echocardiographic analysis. Results: Although most TR regressed in these patients immediately after the procedure, 56 patients developed significant TR during follow-up (median 12 years, IQR 8.0-18.0 years). The cumulative incidence of significant TR increased time-dependently (9.4%, 19.8% and 35.2% at 8, 12 and 18 years of follow-up, respectively). Atrial fibrillation (AF) and TR grade ≥2 before PMV were found to be independent predictors of significant TR (HR (95% CI) 3.049 (1.169 to 7.949) and 3.016 (1.303 to 6.982), p=0.023 and 0.010 for pre-PMV AF and pre-PMV TR grade ≥2, respectively). Even after, exclusion of patients with significant TR at baseline, pre-PMV TR grade ≥2 and AF remained important factors of de novo TR development. Mitral valve restenosis was also associated with late significant TR development. Conclusions: Significant TR after successful PMV in patients with MS is not uncommon long after PMV. TR development is closely associated with mitral valve restenosis. More attention should be paid during long-term follow-up to TR development in patients with MS who have significant pre-PMV TR and/or AF.
AB - Background: Percutaneous mitral valvuloplasty (PMV) is an attractive therapeutic option for mitral stenosis (MS). Objective: To investigate the incidence and development of tricuspid regurgitation (TR) long after successful PMV. Design, patients and interventions: A prospective cohort of 299 patients with symptomatic MS who underwent successful PMV as first-line treatment between 1988 and 2010. Setting: One tertiary university hospital. Main outcome measures: Significant TR, defined as a grade ≥3 on echocardiographic analysis. Results: Although most TR regressed in these patients immediately after the procedure, 56 patients developed significant TR during follow-up (median 12 years, IQR 8.0-18.0 years). The cumulative incidence of significant TR increased time-dependently (9.4%, 19.8% and 35.2% at 8, 12 and 18 years of follow-up, respectively). Atrial fibrillation (AF) and TR grade ≥2 before PMV were found to be independent predictors of significant TR (HR (95% CI) 3.049 (1.169 to 7.949) and 3.016 (1.303 to 6.982), p=0.023 and 0.010 for pre-PMV AF and pre-PMV TR grade ≥2, respectively). Even after, exclusion of patients with significant TR at baseline, pre-PMV TR grade ≥2 and AF remained important factors of de novo TR development. Mitral valve restenosis was also associated with late significant TR development. Conclusions: Significant TR after successful PMV in patients with MS is not uncommon long after PMV. TR development is closely associated with mitral valve restenosis. More attention should be paid during long-term follow-up to TR development in patients with MS who have significant pre-PMV TR and/or AF.
UR - http://www.scopus.com/inward/record.url?scp=84871737209&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2012-302602
DO - 10.1136/heartjnl-2012-302602
M3 - Article
C2 - 22962284
AN - SCOPUS:84871737209
SN - 1355-6037
VL - 99
SP - 91
EP - 97
JO - Heart
JF - Heart
IS - 2
ER -