TRICUSPID REGURGITATION IMPROVEMENT IN RELATION TO THE AMOUNT OF PULMONARY ARTERY PRESSURE REDUCTION

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ZOROUFIAN A.; SAHEBJAM M.; ESLAMI BAHAREH; LOTFI TOKALDANI M.; SHEYKH FATH ELAHI MAHMOUD; KASAIAN S.E.

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Journal: THE JOURNAL OF TEHRAN UNIVERSITY HEART CENTER Year:2010 | Volume:5 | Issue:3 Page(s): 132-136

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Title

TRICUSPID REGURGITATION IMPROVEMENT IN RELATION TO THE AMOUNT OF PULMONARY ARTERY PRESSURE REDUCTION

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Keywords

TRICUSPID VALVE INSUFFICIENCY

BALLOON DILATATION

PULMONARY ARTERY

Abstract

Background: Given the common concomitance of tricuspid regurgitation (TR) with significant mitral stenosis, we aimed at exploring the relation between TR severity and PULMONARY ARTERY hypertension (PAH) in patients who underwent mitral balloon valvotomy (MBV).Methods: We analyzed the echocardiography data of 133 consecutive patients (82.0% female, mean age 44.68±12.56 years) with different degrees of TR severity that underwent MBV between April 2006 and March 2008. The PULMONARY ARTERY systolic pressure (PAPs) > 35 mmHg was considered as PAH.Results: Before MBV, 36.20% of the patients had moderate to severe TR, 92.5% PAH, and 18.0% right ventricular (RV) dilation (RV dimension³33 mm). After MBV, TR severity improved in 41.4%, worsened in 8.3%, and did not change in 50.4%. Before and after MBV, PAPs was significantly correlated with TR severity, and the mean PAPs change in patients with improved TR was significantly more than that of patients without TR improvement (p value=0.042). Tricuspid regurgitation severity and mean PAPs (from 52.83±18.82 to 35.89±9.39 mmHg) decreased significantly after MBV (both p values<0.001); this reduction was significantly correlated to the amount of PAPs decrease. A cut-off point of³19 mmHg reduction in PAPs had a specificity of 71.79% and sensitivity of 52.73% to show TR severity improvement (by Receiver-Operative Characteristics analysis). The mean of RV dimension decreased from 28.94±5.43 to 27.95±4.67 mm (p value<0.001). In contrast to patients with RV dilation, TR reduced significantly in patients without RV dilation (p value<0.001).Conclusion: Improvement in TR severity was directly correlated with the amount of PAPs reduction after MBV. More studies are needed to better define a cut-off value for PAPs reduction related to TR severity improvement.

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