背景:三尖瓣反流(TR)是全球常见的瓣膜性心脏病,目前的TR治疗指南相对保守,以及有害的结果。据报道,窦性心律的恢复可改善房颤(AF)TR患者的TR严重程度。然而,相关研究有限。本荟萃分析的目的是评估房颤患者窦性心律恢复的临床结果。
方法:在本研究中,PubMed,WebofScience,和Scopus数据库被搜索到2023年7月之前的研究登记。本研究是在系统评价和荟萃分析的首选报告项目的指导下设计的。这些包含患者基线特征的研究,外科手术,纳入了至少一项临床结局.主要终点是窦性心律恢复后随访期间的TR等级。
结果:在1074条记录中,6人报名。窦性心律的恢复与TR严重程度的降低相关(TR等级,比值比0.11,95%置信区间(CI):0.01至1.28,P=0.08,I2=83%;TR面积,平均差(MD)-2.19cm2,95%CI:-4.17至-0.21cm2,P=0.03,I2=96%)。此外,右心脏重塑,三尖瓣环直径显着减小(MD-0.36cm,95CI:-0.47至-0.26厘米,P<0.00001,I2=29%)和右心房体积指数(MD-11.10mL/m2,95CI:-16.81至-5.39mL/m2,P=0.0001,I2=79%)。
结论:结论:心律控制治疗可降低房颤患者的TR严重程度,并与右心重构相关。
BACKGROUND: Tricuspid regurgitation (TR) is a common valvular heart disease worldwide, and current guidelines for TR treatment are relatively conservative, as well as with detrimental outcomes. Restoration of sinus rhythm was reported to improve the TR severity in those TR patients with atrial fibrillation (AF). However, relevant research was limited. The aim of this meta-analysis was to evaluate the clinical outcomes of restoration of sinus rhythm in TR patients with AF.
METHODS: In this study, PubMed, Web of Science, and Scopus databases were searched for study enrollment until July 2023. This study was designed under the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. These studies containing the patient\'s baseline characteristics, surgical procedure, and at least one of the clinical outcomes were included. The primary endpoint was TR grade during follow-up after restoration of sinus rhythm.
RESULTS: Out of 1074 records, 6 were enrolled. Restoration of sinus rhythm is associated with a reduction of TR severity (TR grade, odds ratio 0.11, 95% confidence interval (CI): 0.01 to 1.28, P = 0.08, I2 = 83%; TR area, mean difference (MD) -2.19 cm2, 95% CI: -4.17 to -0.21 cm2, P = 0.03, I2 = 96%). Additionally, remolding of right heart with a significant reduction of tricuspid valve annulus diameter (MD -0.36 cm, 95%CI: -0.47 to -0.26 cm, P < 0.00001, I2 = 29%) and right atrium volume index (MD -11.10 mL/m2, 95%CI: -16.81 to -5.39 mL/m2, P = 0.0001, I2 = 79%) was observed during follow-up.
CONCLUSIONS: In conclusion, rhythm-control therapy could reduce TR severity in AF patients with TR and is associated with right heart remodeling.