Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Right Ventricle Assessment before Tricuspid Valve Interventions

Angelica Cersosimo
ORCID logo ,
Mara Gavazzoni
ORCID logo ,
Riccardo Maria Inciardi
ORCID logo ,
Marianna Adamo
,
Gianmarco Arabia
ORCID logo ,
Marco Metra
,
Riccardo Raddino
,
Enrico Vizzardi
* ORCID logo
Version 1 : Received: 5 June 2023 / Approved: 5 June 2023 / Online: 5 June 2023 (13:10:08 CEST)

A peer-reviewed article of this Preprint also exists.

Cersosimo, A.; Gavazzoni, M.; Inciardi, R.M.; Radulescu, C.I.; Adamo, M.; Arabia, G.; Metra, M.; Raddino, R.; Vizzardi, E. Right Ventricle Assessment before Tricuspid Valve Interventions. Journal of Cardiovascular Medicine 2023, 25, 95–103, doi:10.2459/jcm.0000000000001574. Cersosimo, A.; Gavazzoni, M.; Inciardi, R.M.; Radulescu, C.I.; Adamo, M.; Arabia, G.; Metra, M.; Raddino, R.; Vizzardi, E. Right Ventricle Assessment before Tricuspid Valve Interventions. Journal of Cardiovascular Medicine 2023, 25, 95–103, doi:10.2459/jcm.0000000000001574.

Abstract

In new Guideline for the Management of Patients with Valvular Heart Disease for tricuspid regurgitation (TR) is focused the importance of measurement of right-sided diastolic pressures and right ventriculography, pulmonary artery pressures, and pulmonary vascular resistance. Assessment of right ventricular (RV) dimensions and function is pivotal to select patients with severe tricuspid regurgitation who may benefit from tricuspid valve intervention. However, with the exception of tricuspid valve annulus diameter, there is no other cut-off value that defines severe RV dysfunction or dilation for this specific group of patients. It may be difficult, if not impossible, to establish a cut-off value of RV dysfunction since the RV may be exposed to pressure and volume overload, myocardial ischemia, intrinsic myocardial disease or pericardial constraint. Furthermore, the response of the RV to tricuspid valve intervention may vary according to each aetiology and the time course of the disease (acute or chronic). Comprehensive assessment of RV function should address in shape remodelling; functional remodelling; tissue remodelling. This assessment should be performed in optimal loading conditions and after euvolemia has been achieved. It’s now that there is no other cut-off value that defines severe RV dysfunction or dilation for patients with severe TR with the exception of tricuspid valve annulus diameter. It may be difficult, if not impossible, to establish a cut-off value of RV dysfunction since the RV may be exposed to pressure and volume overload, myocardial ischemia, intrinsic myocardial disease or pericardial constraint. In this review we analyze the relationship between right ventricular (RV) and TR in term of outcomes and mortality predictor in patients undergoing percutaneous or invasive treatment for severe TR.

Keywords

right ventricular; tricuspid valve; tricuspid regurgitation; right ventricular remodeling

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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