Objective:To investigate the clinical value of right ventricular dysfunction(RVD)in predicting the efficacy of primary mitral regurgitation(MR)after transcatheter mitral valve repair(TMVR).Methods:A total of 60 patients with moderate to symptomatic MR who visited our hospital from March 2019 to May 2021 were enrolled as the study subjects.According to whether the right ventricular ejection fraction(RVEF)in cardiovascular magnetic resonance imaging(CMR)was lower than 45％,they were divided into an MR+RVD group(n=25)and a simple MR group(n=35).To explore the value of RVD in predicting postoperative mortality and hospital readmissions in patients with MR.Results:Sixteen patients(26.7％)showed right ventricular(RV)dilation.During followed up,fourteen patients died from all causes(23.3％)and twenty patients(33.3％)were readmitted to the hospital due to heart failure and other reasons.According to the receiver operating characteristic curve,the cut-off values of RVEF to predict death and readmissions was 34.6％and 44.9％.In patients with MR,there were positive correlations between left and right ventricular systolic volume index,left and right ventricular stroke volume index,LVEF and REVF(r=0.420,0.490,0.447;P＜0.05).RVEF was inversely correlated with pulmonary artery systolic blood pressure(r=-0.292,P=0.028).After adjusting left ventricular parameters,RVD can also predict the risk of read mission and all-cause death(P＜0.05).Compared with the MR group alone,the time to readmission and all-cause death in the MR+RVD group were shorter(P＜0.05).Conclusions:Even after an effective TMVR,preoperative RVD is associated with a poor prognosis.Cohorts of patients with concurrent RVD,RV dilation,and pulmonary hypertension showed higher all-cause mortality.
关键词
右心室功能障碍/原发性二尖瓣反流/经导管二尖瓣修复术/预后
Key words
Right ventricular dysfunction/Primary mitral regurgitation/Transcatheter mitral valve repair/Prognosis
维普
万方数据