A study evaluated the clinical characteristics, associated factors, and outcomes of worsening tricuspid regurgitation (TR) after pericardiectomy. The findings appeared in the journal Cardiovascular Imaging.
This retrospective study consisted of 381 consecutive patients who underwent pericardiectomy for constrictive pericarditis without tricuspid valve surgery between 2000 to 2017 and had pre- and postoperative echocardiography available. The researchers assessed clinical, imaging, hemodynamic, and mortality characteristics.
The results showed that worsening TR was correlated with a history of congestive heart failure (47.2% vs. 31.9%, P=0.003), increased left atrial volume indexed (23 vs. 20 mL/m2, P=0.020), reduced right ventricular fractional area change (47% vs. 54%, P<0.001), and worsening mitral regurgitation (39.7% vs. 16.6%, P<0.001).
According to the findings, worsened TR showed a trend toward reduced survival during follow-up (P=0.080). This relationship was especially pronounced for patients with worsened TR but no recovery of TR grade on subsequent echocardiography within the first year compared with those without worsened TR (P=0.02). Multivariable analysis revealed that right ventricular fractional area change, left atrial volume index, left ventricular mass index, pulmonary artery systolic pressure, and right atrial pressure/pulmonary capillary wedge pressure ratio were most associated with worsened TR.
“Worsening TR severity was prevalent after pericardiectomy and had a trend toward reduced survival, especially if TR severity did not recover on subsequent echocardiography. Presence of parameters associated with worsened TR and reduced survival should alert clinicians to carefully manage these patients during follow-up,” the researchers concluded.
Keywords: echocardiography, pericardiectomy, pericarditis, constrictive, tricuspid valve