May 26, 2021Clinical CardiologyOpen Access

Progressive tricuspid regurgitation and elevated pressure gradient after transvenous permanent pacemaker implantation

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Why the study?

The association between postimplant tricuspid regurgitation and heart failure hospitalization in patients without heart failure or preexisting abnormal tricuspid regurgitation and pressure gradient remained unclear.

Does progressive tricuspid regurgitation after permanent pacemaker implantation increase the risk of heart failure hospitalization in patients without baseline heart failure?

Population

1075 patients without HF or baseline abnormal TR undergoing transvenous PPM implantation

Comparison

Progressive postimplant TR and elevated TRPG vs nonprogressive TR

Design

Single-hospital observational cohort study

Authors

WLWei‐Chieh LeeElectrophysiology HFHsiu‐Yu FangInterventional Cardiology HCHuang‐Chung ChenElectrophysiology

Discussion

Member takes

Implication

Progressive postimplant TR after PPM may raise HF hospitalization risk in patients without prior HF; hypothesis-generating and needs prospective validation.

Structured PICO

Does progressive tricuspid regurgitation after permanent pacemaker implantation increase the risk of heart failure hospitalization in patients without baseline heart failure?

Population

1,075 patients who underwent a single ventricular or dual-chamber transvenous permanent pacemaker (PPM) implantation. Excluded: prior valvular surgery, history of HF, LVEF <50%, dilated/hypertrophic cardiomyopathy, and preexisting abnormal TR and TRPG. Mean age ~72, Taiwan-based.

Intervention

Development of progressive postimplant tricuspid regurgitation (defined as increased TR grade of ≥2 degrees and TRPG of >30 mmHg) after transvenous permanent pacemaker implantation

Comparator

Patients who did not develop progressive postimplant tricuspid regurgitation after permanent pacemaker implantation

Outcome

TR progression (TR grade ≥3) and abnormal TRPG levels (PG >30 mmHg)surrogate

Progressive tricuspid regurgitation occurs in nearly one-fifth of patients after permanent pacemaker implantation and is associated with an increased risk of heart failure hospitalization.

Limitations

retrospective nature
data from only one medical center
older age leading to relatively high all-cause mortality
absence of baseline and follow-up right heart size and function by echocardiography

Cite This Study

Lee et al. (2021) studied this question.

synapsesocial.com/papers/6a764f210d7658322f06e183 https://doi.org/10.1002/clc.23656

Topics

Tricuspid regurgitation

View Full Paper

Ask AI

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Implication

Progressive postimplant TR after PPM may raise HF hospitalization risk in patients without prior HF; hypothesis-generating and needs prospective validation.

Progressive tricuspid regurgitation and elevated pressure gradient after transvenous permanent pacemaker implantation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Progressive tricuspid regurgitation and elevated pressure gradient after transvenous permanent pacemaker implantation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider