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Article: Prevalence, predictors and clinical outcome of residual pulmonary hypertension following tricuspid annuloplasty
Title | Prevalence, predictors and clinical outcome of residual pulmonary hypertension following tricuspid annuloplasty |
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Authors | |
Keywords | pulmonary hypertension tricuspid annuloplasty valvular surgery |
Issue Date | 2016 |
Publisher | Wiley-Blackwell Publishing, Inc. The Journal's web site is located at http://jaha.ahajournals.org/ |
Citation | Journal of the American Heart Association, 2016, v. 5 n. 7, article no. e003353 How to Cite? |
Abstract | Background-—Tricuspid annuloplasty is increasingly performed during left heart valve surgery, but the long-term clinical outcome postoperatively is not satisfactory. The aim of this study was to determine whether residual pulmonary hypertension (PHT) contributes to the adverse outcome. Methods and Results-—One-hundred thirty-seven patients (age 61±11 years; men, 30%) who underwent tricuspid annuloplasty during left-side valve surgery were enrolled. The mean pulmonary artery systolic pressure before surgery was 49±13 mm Hg and 32±15 mm Hg following surgery. Patients were divided into 3 groups according to postoperative pulmonary artery systolic pressure: no residual PHT (n=78, 57%), mild residual PHT (n=43, 31%), or significant residual PHT (n=16, 12%). A preoperative larger right ventricular (RV) geometry and tricuspid valve tethering area were associated with mild or significant residual PHT. A total of 24 adverse events (20 heart failures and 4 cardiovascular deaths) occurred during a median follow-up of 25 months. Kaplan–Meier survival curve demonstrated that patients with significant residual PHT had the highest percentage of adverse events followed by those with mild residual PHT. Patients with no residual PHT had a very low risk of adverse events. Multivariable Cox regression analysis revealed that both mild (hazard ratio=4.94; 95% CI =1.34–18.16; P=0.02) and significant residual PHT (hazard ratio=8.67; 95% CI =2.43–30.98; P<0.01) were independent factors associated with adverse events. Conclusions-—The present study demonstrated that 43% of patients who underwent tricuspid annuloplasty had residual PHT. The presence of mild or significant residual PHT was associated with adverse events in these patients. |
Persistent Identifier | http://hdl.handle.net/10722/233537 |
ISSN | 2023 Impact Factor: 5.0 2023 SCImago Journal Rankings: 2.126 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | CHEN, Y | - |
dc.contributor.author | Liu, J | - |
dc.contributor.author | Chan, D | - |
dc.contributor.author | Sit, KY | - |
dc.contributor.author | Wong, CK | - |
dc.contributor.author | Ho, KL | - |
dc.contributor.author | Ho, LM | - |
dc.contributor.author | ZHEN, Z | - |
dc.contributor.author | Lam, YM | - |
dc.contributor.author | Lau, CP | - |
dc.contributor.author | Au, TWK | - |
dc.contributor.author | Tse, HF | - |
dc.contributor.author | Yiu, KH | - |
dc.date.accessioned | 2016-09-20T05:37:26Z | - |
dc.date.available | 2016-09-20T05:37:26Z | - |
dc.date.issued | 2016 | - |
dc.identifier.citation | Journal of the American Heart Association, 2016, v. 5 n. 7, article no. e003353 | - |
dc.identifier.issn | 2047-9980 | - |
dc.identifier.uri | http://hdl.handle.net/10722/233537 | - |
dc.description.abstract | Background-—Tricuspid annuloplasty is increasingly performed during left heart valve surgery, but the long-term clinical outcome postoperatively is not satisfactory. The aim of this study was to determine whether residual pulmonary hypertension (PHT) contributes to the adverse outcome. Methods and Results-—One-hundred thirty-seven patients (age 61±11 years; men, 30%) who underwent tricuspid annuloplasty during left-side valve surgery were enrolled. The mean pulmonary artery systolic pressure before surgery was 49±13 mm Hg and 32±15 mm Hg following surgery. Patients were divided into 3 groups according to postoperative pulmonary artery systolic pressure: no residual PHT (n=78, 57%), mild residual PHT (n=43, 31%), or significant residual PHT (n=16, 12%). A preoperative larger right ventricular (RV) geometry and tricuspid valve tethering area were associated with mild or significant residual PHT. A total of 24 adverse events (20 heart failures and 4 cardiovascular deaths) occurred during a median follow-up of 25 months. Kaplan–Meier survival curve demonstrated that patients with significant residual PHT had the highest percentage of adverse events followed by those with mild residual PHT. Patients with no residual PHT had a very low risk of adverse events. Multivariable Cox regression analysis revealed that both mild (hazard ratio=4.94; 95% CI =1.34–18.16; P=0.02) and significant residual PHT (hazard ratio=8.67; 95% CI =2.43–30.98; P<0.01) were independent factors associated with adverse events. Conclusions-—The present study demonstrated that 43% of patients who underwent tricuspid annuloplasty had residual PHT. The presence of mild or significant residual PHT was associated with adverse events in these patients. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell Publishing, Inc. The Journal's web site is located at http://jaha.ahajournals.org/ | - |
dc.relation.ispartof | Journal of the American Heart Association | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | pulmonary hypertension | - |
dc.subject | tricuspid annuloplasty | - |
dc.subject | valvular surgery | - |
dc.title | Prevalence, predictors and clinical outcome of residual pulmonary hypertension following tricuspid annuloplasty | - |
dc.type | Article | - |
dc.identifier.email | Ho, LM: lmho@hkucc.hku.hk | - |
dc.identifier.email | Lau, CP: cplau@hkucc.hku.hk | - |
dc.identifier.email | Au, TWK: auwkt@hkucc.hku.hk | - |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | - |
dc.identifier.email | Yiu, KH: khkyiu@hku.hk | - |
dc.identifier.authority | Ho, LM=rp00360 | - |
dc.identifier.authority | Tse, HF=rp00428 | - |
dc.identifier.authority | Yiu, KH=rp01490 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1161/JAHA.116.003353 | - |
dc.identifier.pmid | 27451465 | - |
dc.identifier.pmcid | PMC5015373 | - |
dc.identifier.scopus | eid_2-s2.0-85032384151 | - |
dc.identifier.hkuros | 263155 | - |
dc.identifier.volume | 5 | - |
dc.identifier.issue | 7 | - |
dc.identifier.spage | article no. e003353 | - |
dc.identifier.epage | article no. e003353 | - |
dc.identifier.isi | WOS:000386713800025 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 2047-9980 | - |