Key result
A preoperative TAPSE/RVSP ratio < 0.42 mm/mmHg independently predicted a higher risk of 30-day mortality (HR 13.54) in patients with severe secondary mitral regurgitation undergoing mitral valve surgery.
Why the study?
The study aimed to assess whether parameters of right ventricle function, specifically right ventricle to pulmonary artery coupling, predict short-term mortality in patients with severe secondary mitral regurgitation following mitral valve surgery.
Does a preoperative TAPSE/RVSP ratio < 0.42 mm/mmHg predict 30-day mortality in patients with severe secondary mitral regurgitation undergoing elective mitral valve surgery?
Cohort (n=112)
No
Does a preoperative TAPSE/RVSP ratio < 0.42 mm/mmHg predict 30-day mortality in patients with severe secondary mitral regurgitation undergoing elective mitral valve surgery?
Hazard Ratio: 13.54 (95% CI 1.44–127.58)
p-value: p=0.023
A preoperative TAPSE/RVSP ratio < 0.42 mm/mmHg is a strong, independent predictor of 30-day mortality in patients undergoing surgery for severe secondary mitral regurgitation.
May support preoperative risk stratification in secondary mitral regurgitation; leaves open prospective validation before guiding surgical decisions.
BACKGROUND: The aim of the study was to assess some parameters of right ventricle (RV) function as predictors of short-term mortality in patients with severe secondary mitral regurgitation (SMR) after mitral valve surgery. METHODS: We conducted a retrospective analysis of 112 consecutive patients with severe SMR who had undergone mitral valve repair or replacement with or without concomitant coronary artery bypass surgery. We assessed RV to pulmonary artery coupling by calculating the ratio of tricuspid annular plane systolic excursion (TAPSE) to non-invasively estimated RV systolic pressure (RVSP). The study endpoint was 30 days post-procedural mortality. RESULTS: Overall, the 30-day mortality was 6%. TAPSE/RVSP ratio < 0.42 mm/mmHg was a significant predictor of mortality and remained so after adjusting for age and sex. The Kaplan-Meier survival analysis showed that patients with RVSP > 55 mmHg and those with TAPSE/RVSP ratio < 0.42 mm/mmHg had a lower survival probability. CONCLUSIONS: TAPSE/RVSP < 0.42 mm/mmHg is a strong predictor of short-term mortality in patients with SMR when considered for valve surgery.
No takes yet. Share an insight, caveat, or question.
Rzucidło-Resil et al. (2023) conducted a cohort in Severe secondary mitral regurgitation (n=112). TAPSE/RVSP ratio < 0.42 mm/mmHg vs. TAPSE/RVSP ratio ≥ 0.42 mm/mmHg was evaluated on 30-day postoperative mortality (HR 13.54, 95% CI 1.44-127.58, p=0.023). A preoperative TAPSE/RVSP ratio < 0.42 mm/mmHg independently predicted a higher risk of 30-day mortality (HR 13.54) in patients with severe secondary mitral regurgitation undergoing mitral valve surgery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: