Conventional echocardiographic parameters or three-dimensional echocardiography to evaluate right ventricular function in percutaneous edge-to-edge mitral valve repair (PMVR)

Abstract

Introduction In this study, we evaluated right ventricular (RV) function before and after percutaneous mitral valve repair (PMVR) using conventional echocardiographic parameters and novel 3DE data sets acquired prior to and directly after the procedure. Patients and methods Observational study on 45 patients undergoing PMVR at an university hospital. Results In the overall collective, the 3D RV-EF before and after PMVR showed no significant change (p = 0.16). While there was a significant increase of the fractional area change (FAC, from 23 [19–29] % to 28 [24–33] %, p = 0.001), no significant change of the tricuspid annular plane systolic excursion (TAPSE, from 17 ± 6 mm to 18 ± 5 mm (standard deviation), p = 0.33) was observed. Regarding patients with a reduced RV-EF (< 35%), a significant RV-EF improvement was observed (from 27 [23–34] % to 32.5 [30–39] % (p = 0.001). 71.4% of patients had an improved clinical outcome (improvement in 6-minute walk test and/or improvement in NYHA class of more than one grade), whereas clinical outcome did not improve in 28.6% of patients. Using univariate logistic regression analysis, the post-PMVR RV-EF (OR 1.15: 95% CI 1.02–1.29; p = 0.02) and the change in RV-EF (OR 1.13: 95% CI 1.02–1.25; p = 0.02) were significant predictors for improved clinical outcome at 6 months follow up. Conclusion Thus, RV function may be an important non-invasive parameter to add to the predictive parameters indicating a potential clinical benefit from treatment of severe mitral regurgitation using PMVR.

Right Ventricular Function Improves Early After Percutaneous Mitral Valve Repair in Patients Suffering From Severe Mitral Regurgitation

“…In your study we were able to detect changes in RV function in the setting of PMVR, but only by using more advanced echocardiographic methods. This is in line with reports showing improvement in 3D RVEF after PVMR ( 34 , 46 ).…”

RV Myocardial Work Reserve as Clinical Improvement Predictor in HFrEF Patients after TEER-A Pilot Study

“…Multiple concise studies have pinpointed immediate bene ts post TEER in terms of pulmonary hypertension regression and RV dysfunction recovery, with the enhancements linked to superior outcomes [19][20][21][22][23][24] . However, literature on the trajectory of RVMW post TEER is scarce, and juxtapositions of RVMW alterations with other traditional RV function parameter shifts after TEER remain uncharted.…”

Significance of Right Ventricular Myocardial Work for Clinical Improvement in Heart Failure with Reduced Ejection Fraction Patients after Transcatheter Edge-To-Edge Repair

“…Alleviating a component of RV overload via SMR correction can potentially bolster RV contractility. Multiple concise studies have pinpointed immediate benefits post TEER in terms of pulmonary hypertension regression and RV dysfunction recovery, with the enhancements linked to superior outcomes [19][20][21][22][23][24]. However, literature on the trajectory of RVMW post TEER is scarce, and juxtapositions of RVMW alterations with other traditional RV function parameter shifts after TEER remain uncharted.…”