PDF(Pubmed)
Abstract：
UNASSIGNED: The improvement rate and predictors of secondary mitral regurgitation in patients with aortic regurgitation undergoing transcatheter aortic valve replacement (TAVR) remain unclear. This study aimed to identify predictors of persistent moderate to severe secondary mitral regurgitation after TAVR in patients with aortic regurgitation by assessing mitral valve geometry with computed tomography (CT).
UNASSIGNED: This retrospective cohort study reviewed 242 consecutive patients with aortic regurgitation who underwent TAVR between May 2014 and December 2022. Patients with primary or less than moderate mitral regurgitation were excluded. Mitral annular dimensions (area, perimeter, anteroposterior, intercommissural, and trigone-to-trigone diameter), mitral valve tenting geometry (mitral valve tenting area [MVTA] and mitral valve tenting height [MVTH]), and papillary muscle displacement were systematically measured at CT. Mitral regurgitation improvement was assessed at 3 months after TAVR by echocardiography. Logistic regression was performed to explore the association of mitral valve geometry with mitral regurgitation improvement after TAVR.
UNASSIGNED: A total of 75 patients (mean age, 74 ± 7 years; 32.0% female) with moderate to severe secondary mitral regurgitation were included in the final analysis. Mitral regurgitation improved in 49 patients and remained unchanged in 26 patients. Mitral annular dimensions, including area, perimeter, anteroposterior, and intercommissural diameter, were associated with mitral regurgitation improvement. MVTA and MVTH were risk factors for sustained mitral regurgitation. In addition, QRS duration > 120 ms and atrial fibrillation had an impact on the mitral regurgitation improvement. Mitral annular area (odds ratio [OR], 1.41; 95% confidence interval [CI]: 1.05, 1.90; p = 0.02) and MVTA (OR, 7.24; 95% CI: 1.72, 30.44; p = 0.007) were independent predictors of persistent secondary mitral regurgitation after TAVR.
UNASSIGNED: Mitral annular area and MVTA were independent predictors of persistent secondary mitral regurgitation after TAVR.
UNASSIGNED: This retrospective cohort study reviewed 242 consecutive patients with aortic regurgitation who underwent TAVR between May 2014 and December 2022. Patients with primary or less than moderate mitral regurgitation were excluded. Mitral annular dimensions (area, perimeter, anteroposterior, intercommissural, and trigone-to-trigone diameter), mitral valve tenting geometry (mitral valve tenting area [MVTA] and mitral valve tenting height [MVTH]), and papillary muscle displacement were systematically measured at CT. Mitral regurgitation improvement was assessed at 3 months after TAVR by echocardiography. Logistic regression was performed to explore the association of mitral valve geometry with mitral regurgitation improvement after TAVR.
UNASSIGNED: A total of 75 patients (mean age, 74 ± 7 years; 32.0% female) with moderate to severe secondary mitral regurgitation were included in the final analysis. Mitral regurgitation improved in 49 patients and remained unchanged in 26 patients. Mitral annular dimensions, including area, perimeter, anteroposterior, and intercommissural diameter, were associated with mitral regurgitation improvement. MVTA and MVTH were risk factors for sustained mitral regurgitation. In addition, QRS duration > 120 ms and atrial fibrillation had an impact on the mitral regurgitation improvement. Mitral annular area (odds ratio [OR], 1.41; 95% confidence interval [CI]: 1.05, 1.90; p = 0.02) and MVTA (OR, 7.24; 95% CI: 1.72, 30.44; p = 0.007) were independent predictors of persistent secondary mitral regurgitation after TAVR.
UNASSIGNED: Mitral annular area and MVTA were independent predictors of persistent secondary mitral regurgitation after TAVR.
摘要：
■经导管主动脉瓣置换术（TAVR）主动脉瓣返流患者继发性二尖瓣返流的改善率和预测因素尚不清楚。本研究旨在通过计算机断层扫描（CT）评估二尖瓣的几何形状，确定TAVR后主动脉瓣返流患者持续中度至重度继发性二尖瓣返流的预测因素。
这项回顾性队列研究回顾了在2014年5月至2022年12月期间接受TAVR的242例主动脉瓣返流患者。排除患有原发性或中度以下二尖瓣返流的患者。二尖瓣环尺寸(面积,周边,前后，跨委员会，和三角直径)，二尖瓣隆起几何形状（二尖瓣隆起面积[MVTA]和二尖瓣隆起高度[MVTH]），在CT上系统地测量了乳头状肌位移。通过超声心动图在TAVR后3个月评估二尖瓣反流的改善。进行Logistic回归分析以探讨二尖瓣几何形状与TAVR后二尖瓣反流改善的关系。
■总共75名患者(平均年龄，74±7岁；32.0%女性）中度至重度继发性二尖瓣反流被纳入最终分析。49例患者二尖瓣反流得到改善，26例患者无变化。二尖瓣环尺寸,包括面积,周边,前后，连合间直径，与二尖瓣反流改善有关。MVTA和MVTH是持续二尖瓣反流的危险因素。此外,QRS持续时间>120ms和心房颤动对二尖瓣反流的改善有影响。二尖瓣环面积（比值比[OR]，1.41；95%置信区间[CI]：1.05，1.90；p=0.02）和MVTA（OR，7.24;95%CI:1.72,30.44;p=0.007)是TAVR后持续性继发性二尖瓣反流的独立预测因子。
■二尖瓣环面积和MVTA是TAVR后持续性继发性二尖瓣返流的独立预测因子。
这项回顾性队列研究回顾了在2014年5月至2022年12月期间接受TAVR的242例主动脉瓣返流患者。排除患有原发性或中度以下二尖瓣返流的患者。二尖瓣环尺寸(面积,周边,前后，跨委员会，和三角直径)，二尖瓣隆起几何形状（二尖瓣隆起面积[MVTA]和二尖瓣隆起高度[MVTH]），在CT上系统地测量了乳头状肌位移。通过超声心动图在TAVR后3个月评估二尖瓣反流的改善。进行Logistic回归分析以探讨二尖瓣几何形状与TAVR后二尖瓣反流改善的关系。
■总共75名患者(平均年龄，74±7岁；32.0%女性）中度至重度继发性二尖瓣反流被纳入最终分析。49例患者二尖瓣反流得到改善，26例患者无变化。二尖瓣环尺寸,包括面积,周边,前后，连合间直径，与二尖瓣反流改善有关。MVTA和MVTH是持续二尖瓣反流的危险因素。此外,QRS持续时间>120ms和心房颤动对二尖瓣反流的改善有影响。二尖瓣环面积（比值比[OR]，1.41；95%置信区间[CI]：1.05，1.90；p=0.02）和MVTA（OR，7.24;95%CI:1.72,30.44;p=0.007)是TAVR后持续性继发性二尖瓣反流的独立预测因子。
■二尖瓣环面积和MVTA是TAVR后持续性继发性二尖瓣返流的独立预测因子。
