Aim of the study is to investigate the prognostic value of right ventricular contractile reserve in patients with functional tricuspid regurgitation undergoing tricuspid valve repair or replacement.
Chronic volume overload in patients with severe tricuspid regurgitation (TR) leads to right ventricular (RV) dilatation, fibrosis and eventually failure. RV dysfunction is an important determinant of mortality in patients undergoing tricuspid valve surgery. Aim of the current study is to investigate the prognostic utility of right ventricular contractile reserve in patients with severe TR undergoing surgical or interventional tricuspid valve repair or tricuspid valve replacement. RV contractile reserve will be assessed using semi-supine bicycle stress echocardiography. Echocardiographic parameters are prone to altered loading conditions, such as volume overload. Load independent RV contractility can only be measured using invasive pressure-volume-loop (PVL) analysis. Therefore RV PVL analysis will be done using conductance catheter in a subset of patients who undergo right heart catheterization for clinical evaluation of pulmonary hypertension. Aim of this sub study is the validation of non-invasively derived RV contractile reserve with load independent markers of intrinsic RV contractility.
Study Type
OBSERVATIONAL
Enrollment
108
Dynamic stress echocardiography using a cycle ergometer on a semi supine exercise table.
Pressure volume loop analysis unsing conductance catheter measurements during right heart catheterization.
Tricuspid valve repair or replacement using a surgical or interventionale approach according to local heart team recommendation and patients' preference.
Heart Center Leipzig at Leipzig University
Leipzig, Germany
RECRUITINGDeath or heart failure hospitalization
Death or heart failure hospitalization according to right ventricular contractile reserve.
Time frame: 6-12 month
Death
Death according to right ventricular contractile reserve.
Time frame: 6-12 month
Cardiovascular Death
Cardiovascular Death according to right ventricular contractile reserve.
Time frame: 6-12 month
Heart Failure Hospitalization
Heart Failure Hospitalization according to right ventricular contractile reserve.
Time frame: 6-12 month
Intrinsic RV contractility
Correlation of RV contractile reserve with the slope of invasively derived right ventricular end systolic elastance.
Time frame: Baseline
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