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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Heart Valve Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1463978
This article is part of the Research Topic Tricuspid regurgitation - Time to assess more than the prognosis View all 3 articles

Predictive value of CT-based and AI-reconstructed 3D-TAPSE in patients undergoing transcatheter tricuspid valve repair

Provisionally accepted
Johannes Kirchner Johannes Kirchner *Muhammed Gerçek Muhammed Gerçek Hazem Omran Hazem Omran Kai Friedrichs Kai Friedrichs Felix Rudolph Felix Rudolph Tobias Rossnagel Tobias Rossnagel Misagh Piran Misagh Piran Arseniy Goncharov Arseniy Goncharov Maria Ivannikova Maria Ivannikova Volker Rudolph Volker Rudolph Tanja Katharina Rudolph Tanja Katharina Rudolph
  • Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany

The final, formatted version of the article will be published soon.

    The tricuspid annular plane systolic excursion (TAPSE) assessed by echocardiography has failed to predict outcome in patients with severe tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve intervention (TTVI).Considering the complex shape of the tricuspid annulus and right ventricle as well as difficult echocardiographic image acquisition of the right heart, cardiac computed tomography (CT) might be superior for the analysis of the annular excursion. Thus, this study sought to analyze whether CT captured TAPSE might provide additive value in outcome prediction after TTVI.For TTVI procedure planning, 75 patients (mean age 77±8 years, 61% female) with ≥severe TR underwent full cardiac cycle CT. Septal, lateral, anterior and posterior TAPSE as well as TAPSE-volume were analyzed. Indexed anterior, posterior (iTAPSE) and TAPSE-volume were reduced in patients with right ventricular ejection fraction <45%.At 1 year after TTVI (mean follow-up was 193±146days) the combined endpoint of death and rehospitalization occurred in significantly fewer patients with posterior iTAPSE>4.5mm/m² (17.2% vs. 63.6%; HR 0.225, CI 0.087-0.581; P<0.001) and in patients with iTAPSE-volume>9ml/m² (16.4% vs. 57.1%; HR: 0.269 CI 0.105-0.686; P=0.003). Echocardiographic TAPSE correlated best with lateral CTbased TAPSE but both failed to predict the outcome after TTVI. In multivariate Cox-regression, posterior iTAPSE was found to be a significant predictor of outcome one year after TTVI.Posterior iTAPSE is an independent predictor of cardiovascular outcome among patients undergoing TTVI. Furthermore, CT-measured TAPSE has incremental value and refines risk stratification for clinical outcome in patients undergoing TTVI.

    Keywords: computed tomography, Tricuspid Valve, TTVI, TAPSE, right ventricle, Outcome

    Received: 12 Jul 2024; Accepted: 13 Dec 2024.

    Copyright: © 2024 Kirchner, Gerçek, Omran, Friedrichs, Rudolph, Rossnagel, Piran, Goncharov, Ivannikova, Rudolph and Rudolph. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Johannes Kirchner, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany

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