Key result
Early RV dyssynchrony predicts a ~54% higher risk of TR progression after pacemaker implantation.
Why the study?
The role of procedural aspects and advanced echocardiographic parameters in predicting tricuspid regurgitation progression after permanent pacemaker implantation remains incompletely defined.
Do procedural factors and early echocardiographic parameters predict progression to moderate-to-severe tricuspid regurgitation following permanent pacemaker implantation?
Cohort (n=52)
Do procedural factors and early echocardiographic parameters predict progression to moderate-to-severe tricuspid regurgitation following permanent pacemaker implantation?
Answers are grounded in this paper and cite their sources.
Early abnormalities in right ventricular strain and mechanical dyssynchrony, along with procedural factors, independently predict progression to moderate-to-severe tricuspid regurgitation after pacemaker implantation.
BACKGROUND: Tricuspid regurgitation (TR) progression is a recognized complication following permanent pacemaker (PPM) implantation with a significant impact on morbidity and mortality. The role of procedural aspects as well as advanced echocardiographic parameters in predicting TR progression remains incompletely defined. OBJECTIVE: To investigate procedural factors and echocardiographic parameters predicting progression to moderate-to-severe TR following PPM implantation. METHODS: Fifty-two consecutive patients undergoing PPM implantation were prospectively included. Conventional echocardiography and speckle-tracking echocardiography (STE) were performed at baseline, 3 months, and 6 months post-implantation. Patients were classified according to the development of moderate-to-severe TR during follow-up. RESULTS: Moderate-to-severe TR developed in 17 patients (32.7%) during follow-up. Baseline clinical and echocardiographic parameters were largely comparable between groups, although patients with subsequent TR progression had mildly impaired baseline RV free wall longitudinal strain (RV-FWLS) (p = 0.04). At 3 months, patients with TR progression demonstrated worse RV-FWLS (p = 0.01), higher RV dyssynchrony index (p = 0.02), and larger tricuspid annular diameter (p = 0.04). On multivariable analysis, the direct trans-tricuspid crossing technique (OR 5.42, 95% CI 1.01-29.12; p = 0.048), ventricular pacing burden (OR 1.39, 95% CI 1.05-1.86; p = 0.02), 3-month RV-FWLS (OR 1.47, 95% CI 1.01-2.15; p = 0.04) and 3-month RV dyssynchrony index (OR 1.54, 95% CI 1.02-2.31; p = 0.03) could independently predicted TR progression. ROC analysis showed good predictive performance for RV dyssynchrony index (AUC 0.86) and RV-FWLS (AUC 0.83). CONCLUSIONS: Early abnormalities in RV strain and mechanical dyssynchrony were associated with subsequent TR progression following PPM implantation, highlighting the potential value of advanced echocardiographic assessment for early risk stratification.
No takes yet. Share an insight, caveat, or question.
Ibrahim et al. (2026) conducted a cohort in Tricuspid regurgitation progression (n=52). Procedural factors and advanced echocardiographic parameters (RV strain and dyssynchrony) vs. Patients without TR progression was evaluated on Progression to moderate-to-severe tricuspid regurgitation (OR 1.54, 95% CI 1.02-2.31, p=0.03). Early abnormalities in RV strain and mechanical dyssynchrony, such as 3-month RV dyssynchrony index (OR 1.54; 95% CI 1.02-2.31), independently predicted TR progression after pacemaker implantation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: