Influence of functional tricuspid regurgitation on right ventricular function Takaki Sugimoto, MD, Masayoshi Okada, MD, Nobuchika Ozaki, MD, Toshihiro.

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Influence of functional tricuspid regurgitation on right ventricular function Takaki Sugimoto, MD, Masayoshi Okada, MD, Nobuchika Ozaki, MD, Toshihiro Kawahira, MD, Masato Fukuoka, MD The Annals of Thoracic Surgery Volume 66, Issue 6, Pages 2044-2050 (December 1998) DOI: 10.1016/S0003-4975(98)01041-8

Fig 1 Preoperative right heart parameters. In groups 2 and 3, the right heart parameters had deteriorated to the point that tricuspid regurgitation repair was necessary. Group 1: preoperative tricuspid annular diameter (TAD) at end-diastole <40 mm; group 2: TAD = 40 to 50 mm; group 3: TAD ≧ 50 mm. Values are expressed as the mean ± standard deviation. (ICG(k) = k value of indocyanine green measurement; RAm = right atrial mean pressure; RVEDP = right ventricular end-diastolic pressure; PAm = pulmonary arterial mean pressure; RVEDVI = right ventricular end-diastolic volume index; RVESVI = right ventricular end-systolic volume index; RVEF = right ventricular ejection fraction; ∗p < 0.05.) The Annals of Thoracic Surgery 1998 66, 2044-2050DOI: (10.1016/S0003-4975(98)01041-8)

Fig 2 Preoperative correlation between pulmonary arteriolar resistance index (PARI, x axis) and right ventricular forward stroke work index (RVFSWI, y axis) in each of the three groups. As PARI increased, RVFSWI increased in a linear fashion. The slope of the regression line was gentler in groups 1, 2, and 3 in that order. The Annals of Thoracic Surgery 1998 66, 2044-2050DOI: (10.1016/S0003-4975(98)01041-8)

Fig 3 Change of correlation between pulmonary arteriolar resistance index (PARI) and right ventricular forward stroke work index (RVFSWI) after operation in each of the three groups. The regression line moved parallel in group I (a), and the slopes became steeper in groups 2 (b) and 3 (c). The Annals of Thoracic Surgery 1998 66, 2044-2050DOI: (10.1016/S0003-4975(98)01041-8)

Fig 4 Postoperative comparison of the regression lines correlating pulmonary arteriolar resistance index (PARI) and right ventricular forward stroke work index (RVFSWI) among the three groups. The slope of regression line became similar in groups 1 and 2, but still remained gentler in group 3. The Annals of Thoracic Surgery 1998 66, 2044-2050DOI: (10.1016/S0003-4975(98)01041-8)

Fig 5 Changes of the ratio of right ventricular forward stroke work index to pulmonary arteriolar resistance index (RVFSWI/PARI) values after operation (Postop) in each group. The RVFSWI/PARI value was significantly lower in group 3 compared with groups 1 and 2 preoperatively (Preop). Postoperatively, this value showed a significant decrease in group 1, a significant increase in group 2, and no significant change in group 3. Values are expressed as the mean ± standard deviation. (∗p < 0.05.) The Annals of Thoracic Surgery 1998 66, 2044-2050DOI: (10.1016/S0003-4975(98)01041-8)

Fig 6 Changes of right heart parameters after tricuspid regurgitation repair. The right heart parameters significantly improved, but values in group 3 remained worse compared with group 2. Values are expressed as the mean ± standard deviation. (NYHA = New York Heart Association; RAm = right atrial mean pressure; RVEDP = right ventricular end-diastolic pressure; RVEDVI = right ventricular end-diastolic volume index; RVESVI = right ventricular end-systolic volume index; ∗p < 0.05.) The Annals of Thoracic Surgery 1998 66, 2044-2050DOI: (10.1016/S0003-4975(98)01041-8)