Efficacy of shear wave elasticity for predicting clinical outcomes in patients with significant tricuspid regurgitation
Efficacy of shear wave elasticity for predicting clinical outcomes in patients with significant tricuspid regurgitation
复制标题
DOI：
10.1007/s00380-022-02084-1
复制
发表时间：
2022-05-13
影响因子：
1.5
通讯作者：
Ito，Hiroshi
中科院分区：
文献类型：
--
作者：
Nakayama，Rie;Takaya，Yoichi;Ito，Hiroshi
本研究旨在评价剪切波弹性评价三尖瓣反流患者临床结果的有效性。严重的TR发展为右心衰竭(HF)并伴有器官充血，导致不良后果，但适当的治疗策略仍不清楚。使用SW弹性评估肝脏充血程度可能是确定治疗策略的有效方法。我们前瞻性地招募了77名接受西南弹性造影术的中、重度TR患者。根据短波弹性的大小将患者分为三组：低组(短波弹性 <； 6.4kpa，n= 26)，中组(6.4 ≤ 短波弹性 <； 9.5kpa，n= 26)，高组(短波弹性 ≥ 9.5kpa，n= 25)。终点是心血管病死亡或因心力衰竭住院。中位随访期17个月(7~39个月)，高血压组7例，中位组3例，低血压组无一例发生心血管死亡或心力衰竭住院。高血压组有3例死亡，7例因心衰住院。中型组死亡2例，住院1例。Kaplan-Meier分析显示，高组的无事件生存率低于其他组(对数等级检验，p= 0.02)。高Sw弹性与心脏事件以及右室和左心功能不全独立相关。通过评估肝脏充血，Sw弹性是心脏事件的一个预测因子。Sw弹性对确定TR的治疗策略具有重要价值。
This study aimed to evaluate the efficacy of shear wave (SW) elasticity for assessing clinical outcomes in patients with significant tricuspid regurgitation (TR). Significant TR develops right heart failure (HF) with organ congestion, resulting in adverse outcomes, but appropriate therapeutic strategies remain unclear. The assessment of the degree of hepatic congestion using SW elasticity may be effective for determining therapeutic strategies. We prospectively enrolled 77 patients with moderate or severe TR who underwent SW elastography. Patients were divided into three groups according to the value of SW elasticity: low group (SW elasticity < 6.4 kPa,n= 26), medium group (6.4 ≤ SW elasticity < 9.5 kPa,n= 26), and high group (SW elasticity ≥ 9.5 kPa,n= 25). The endpoint was cardiovascular death or hospitalization for HF. During the median follow-up period of 17 months (range 7–39 months), cardiovascular death or hospitalization for HF occurred in seven patients of high group, in three patients of medium group, and in no patients of low group. In high group, three patients died and seven patients were hospitalized for HF. In medium group, two patients died and one patient was hospitalized. Kaplan–Meier analysis showed that the event-free survival rate was worse in high group than in other groups (log-rank test,p= 0.02). High SW elasticity was independently related to cardiac events as well as right ventricular and left ventricular dysfunction. SW elasticity was a predictor of cardiac events in patients with significant TR by assessing hepatic congestion. SW elasticity can be valuable for determining therapeutic strategies for TR.