Background: The mid-term prognosis after transcatheter tricuspid valve replacement (TTVR) is poorly defined, and echocardiographic predictors remain uncertain. Objectives: To describe mid-term all-cause mortality, 30-day major adverse events (MAEs), and echocardiographic risk markers of TTVR. Methods: Consecutive patients undergoing TRAVEL (Transcatheter right atrial-ventricular valve replacement With LuX-Valve) at three centers were retrospectively analyzed. Firth Cox regression was applied for mortality, and Firth logistic regression was used for exploratory MAE analyses. Results: A total of 62 patients (median age 66.5 years [61.0–72.8], 83.8% female) were included. Over a mean follow-up of 46.2 months, seven deaths (11.2%) occurred, corresponding to mid-term survival of 88.8%. Within 30 days, 14 patients (22.6%) experienced MAEs, including three deaths (4.8%), major bleeding in eight (12.9%), surgical re-exploration in seven (11.3%), repeat open-heart tricuspid valve replacement in one (1.6%), and permanent pacemaker implantation in six (9.7%). TR was reduced to mild or less in 95.2% at 1 year. Conclusions: In this LuX-Valve TTVR cohort, 30-day MAEs mainly reflected perioperative or device-related complications rather than a direct signal of baseline RV dysfunction or remodeling. LuX-Valve implantation showed favorable mid-term survival and clinically meaningful procedural effectiveness; RV-centered echocardiographic markers should be considered hypothesis-generating and require validation in larger cohorts.
Xing Zhao, Hao Shi, Ying Peng et al.· Journal of Cardiovascular De...· 0 citations
BACKGROUND
Two-dimensional (2D) speckle-tracking echocardiography (STE) for fibrosis detection has been validated against cardiac magnetic resonance late gadolinium enhancement (CMR-LGE) in hypertrophic cardiomyopathy (HCM), whereas 3-dimensional speckle-tracking echocardiography (3D-STE) may overcome limitations of 2D imaging.
OBJECTIVES
The authors aimed to evaluate whether 3D-STE can quantify replacement fibrosis as a surrogate for CMR-LGE.
METHODS
Two-dimensional speckle-tracking echocardiography, 3D-STE, and the extent of late gadolinium enhancement (%LGE) were prospectively measured in patients with HCM within ≤72 hours.
RESULTS
Among 511 patients with HCM (age 49.0 ± 14.3 years; men 340/511, 66.5%), strain parameters were significantly lower in patients with HCM and LGE [LGE (+)] than those in patients without LGE [LGE (-)]. Three-dimensional global longitudinal strain (GLS-3D) correlated moderately with GLS-2D (r = 0.622; 95% CI: 0.565-0.672; P < 0.001) and most strongly with %LGE (r = -0.698; 95% CI: -0.741 to -0.649; P < 0.001). A quadratic model explained the relationship between GLS-3D and %LGE better than the linear model (R2 = 0.448 vs 0.381). GLS-3D was independently associated with extensive LGE (%LGE ≥15%) (OR = 0.629; 95% CI: 0.553-0.716; P < 0.001), and showed the highest AUC for detecting extensive LGE (AUC = 0.894; 95% CI: 0.854-0.934; P < 0.001). At a cutoff value of 15.25%, GLS-3D yielded 87.3% sensitivity (95% CI: 75.5%-94.7%) and 78.3% specificity (95% CI: 74.4-82.2%).
CONCLUSIONS
GLS-3D showed the strongest correlation with %LGE among strain parameters and may serve as a surrogate marker for CMR-LGE in HCM.
Rong Wang, Li Zhang, Yue Gao et al.· JACC: Asia· 0 citations
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