Evidence map›Paper›PMID 39607781›Full record

ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2024

Right ventricular to pulmonary arterial coupling as a predictor of survival in patients undergoing mitral valve surgery for mitral regurgitation.

Omar Chehab, Edouard Long, Vitaly Androshchuk, Harminder Gill, Vassilios Avlonitis, Paolo Bosco, Gianluca Lucchese, Tiffany Patterson, Simon Redwood, Ronak Rajani

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Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

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6citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Omar ChehabDepartment of Cardiology, St Thomas' Hospital, London, UK.ORCID 0000-0002-4241-3060
Edouard LongGKT School of Medical Education, King's College London, London, UK.ORCID 0009-0002-1008-7966
Vitaly AndroshchukDepartment of Cardiology, St Thomas' Hospital, London, UK.ORCID 0000-0002-1464-3109
Harminder GillDepartment of Cardiology, St Thomas' Hospital, London, UK.ORCID 0000-0003-1527-2263
Vassilios AvlonitisDepartment of Cardiac Surgery, St Thomas' Hospital, London, UK.
Paolo BoscoDepartment of Cardiac Surgery, St Thomas' Hospital, London, UK.
Gianluca LuccheseDepartment of Cardiac Surgery, St Thomas' Hospital, London, UK.
Tiffany PattersonDepartment of Cardiology, St Thomas' Hospital, London, UK.
Simon RedwoodDepartment of Cardiology, St Thomas' Hospital, London, UK.ORCID 0000-0002-1937-063X
Ronak RajaniDepartment of Cardiology, St Thomas' Hospital, London, UK.ORCID 0000-0002-8816-6296

Funding

British Heart Foundation FS/CRTF/22/24312
6 · The paper itself

Abstract

objectivesRight ventricular-to-pulmonary artery coupling has been associated with outcomes in mitral regurgitation treated by transcatheter approaches. We evaluated right ventricular-to-pulmonary artery coupling as a predictor of survival and postoperative length of hospital stay (LOS) in patients with mitral regurgitation undergoing mitral valve surgery.

methodsIn this retrospective analysis (median follow-up: 5.8 years), right ventricular-to-pulmonary artery coupling was quantified as the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) using transthoracic echocardiography. Receiver operating characteristic curve analysis was used to determine the optimum cut-point of TAPSE/PASP to predict all-cause mortality, and the study population was dichotomized according to this value. The primary end point was all-cause mortality. A secondary end point of LOS was also assessed.

resultsOut of 142 patients (median age: 67, female: 49%), 35 showed impaired coupling at baseline (TAPSE/PASP ≤0.35). Patients with TAPSE/PASP ≤0.35 had higher absolute mortality (37% vs 8%, P < 0.001) and longer LOS (7 days vs 9 days, P = 0.04). Kaplan-Meier analysis revealed lower survival in patients with TAPSE/PASP ≤0.35 (log-rank: P < 0.0001). In multivariable Cox regression, TAPSE/PASP ≤0.35 was the most significant predictor of all-cause mortality (hazard ratio: 3.69, 95% confidence interval 1.31-10.1, P = 0.011), alongside chronic obstructive pulmonary disease and estimated glomerular filtration rate. TAPSE/PASP ≤0.35 was associated with significantly increased LOS (β: 4.6, 95% confidence interval 0.66-8.5, P = 0.022) alongside left ventricular ejection fraction, mitral valve replacement and urgent operation.

conclusionsIn mitral regurgitation patients undergoing mitral valve surgery, TAPSE/PASP ≤0.35 is associated with increased mortality and LOS. Further validation is indicated in larger, prospective cohorts.

Indexed as

Mitral ValveMitral Valve InsufficiencyPulmonary ArteryAgedEchocardiographyFemaleHeart Valve Prosthesis ImplantationHeart VentriclesHumansLength of StayMaleMiddle AgedRetrospective StudiesCardiac surgeryMitral regurgitationMitral surgeryRight ventricleRight ventricular pulmonary artery couplingTAPSE/PASP

Identifiers

PMID39607781
PMCPMC11631384

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