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Factors associated with the presence of tricuspid valve regurgitation in patients with systemic right ventricles following atrial switch
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Abstract
Methods: This was a retrospective analysis of the factors predictive of significant TR in 60 patients with systemic right ventricles following an atrial switch procedure for complete transposition of the great arteries. Data from echocardiographic examinations, exercise radionuclide angiography, and myocardial perfusion imaging were analyzed.
Results: Significant TR was present in 20% of patients. Compared to patients without significant TR, patients with significant TR were older at the time of surgery (p ≤ 0.001), with a higher body mass index (p ≤ 0.005), lower right ventricular ejection fraction (RVEF; p ≤ 0.01), higher exercise perfusion abnormalities score on radionuclide angiography (p ≤ 0.03), and higher systolic blood pressure (p ≤ 0.02). At univariate logistic regression analysis systolic blood pressure (p = 0.03), increasing age at surgery (p = 0.01), and RVEF (p = 0.02), were predictors of significant tricuspid regurgitation. The latter two remained significant at multivariate analysis.
Conclusions: Patients operated upon later in life, with decreased RVEF and higher blood pressure, are at risk of significant tricuspid regurgitation and therefore warrant special attention. Prospective studies are needed to ascertain whether appropriate pharmacological intervention would prevent the development and/or progression of TR in these patients.
(Cardiol J 2010; 17, 1: 29-34)
Abstract
Methods: This was a retrospective analysis of the factors predictive of significant TR in 60 patients with systemic right ventricles following an atrial switch procedure for complete transposition of the great arteries. Data from echocardiographic examinations, exercise radionuclide angiography, and myocardial perfusion imaging were analyzed.
Results: Significant TR was present in 20% of patients. Compared to patients without significant TR, patients with significant TR were older at the time of surgery (p ≤ 0.001), with a higher body mass index (p ≤ 0.005), lower right ventricular ejection fraction (RVEF; p ≤ 0.01), higher exercise perfusion abnormalities score on radionuclide angiography (p ≤ 0.03), and higher systolic blood pressure (p ≤ 0.02). At univariate logistic regression analysis systolic blood pressure (p = 0.03), increasing age at surgery (p = 0.01), and RVEF (p = 0.02), were predictors of significant tricuspid regurgitation. The latter two remained significant at multivariate analysis.
Conclusions: Patients operated upon later in life, with decreased RVEF and higher blood pressure, are at risk of significant tricuspid regurgitation and therefore warrant special attention. Prospective studies are needed to ascertain whether appropriate pharmacological intervention would prevent the development and/or progression of TR in these patients.
(Cardiol J 2010; 17, 1: 29-34)
Keywords
congenital heart disease; tricuspid regurgitation; transposition of the great arterie
About this articleTitle
Factors associated with the presence of tricuspid valve regurgitation in patients with systemic right ventricles following atrial switch
Journal
Issue
Pages
29-34
Published online
2010-01-26
Page views
536
Article views/downloads
755
DOI
10.5603/cj.21414
Bibliographic record
Cardiol J 2010;17(1):29-34.
Keywords
congenital heart disease
tricuspid regurgitation
transposition of the great arterie
Authors
Piotr Szymański
Anna Klisiewicz
Barbara Lubiszewska
Marek Konka
Magdalena Lipczyńska
Mariusz Kuśmierczyk
Piotr Hoffman
