Won Jin Choi MD, Presenter: Nothing to Disclose

Dong Hyun Yang MD, Abstract Co-Author: Nothing to Disclose

Joon-Won Kang MD, Abstract Co-Author: Nothing to Disclose

Tae-Hwan Lim MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate right ventricular (RV) function using cardiac magnetic resonance imaging (CMRI) in pateints who underwent tricuspid valvular surgery and to identify predictors of poor prognosis. 

During seven years, 842 patients underwent tricuspid valvular surgery due to moderate or severe tricuspid regurgitation. Among them, 124 patients underwent preoperative CMRI to evaluate right ventricular function. Short-axis cine MRI images were analyzed using dedicated software. Ejection fraction, end-diastolic volume, end-systolic volume, myocardial mass of both ventricles were evaluated. By reviewing electronic medical record, baseline characteristics and patient outcome data. The primary composite outcome was any cause of death, rehospitalization due to aggravated heart failure, and redo open heart surgery. (In this preliminary analysis, results from 62 patients were only available and included in this abstract. Complete results including quantitative analysis of delayed myocardial enhancement and Cox-regression analysis will be presented in the RSNA meeting.) 

Among 62 pateints, the primary outcome rate was 31% (n=19) (median follow-up of 278 days; range 17 – 2120 days). In patient with positive outcome, LV mass index and RV mass index were significantly greater than patient without outcome (LV mass index, AUC 0.747, cut-off 61 g/m2; RV mass index, AUC 0.763, cut-off 27 g/m2). RV ejection fraction was significantly decreased and RV end-systolic volume index was enlarged as compared with those of control group (RV ejection fraction, AUC 0.684, cut-off 36%; RV end-systolic volume, AUC 0.700, cut-off 52ml/m2). Unadjusted Kaplan-Meier survival curves showed significantly lower survival rate in patients with large RV systolic volume and large ventricular mass index of both RV and LV. 

RV function measured by CMRI may provide prognostic information in patients who underwent tricuspid valvular surgery. Measurement of both ventricular mass index and right ventricular end-systolic volume may help to identify pateints with poor prognosis. 

Cardiac MRI may be used for prediction of poor prognosis in pateints who underwent tricuspid valvular surgery. 

Choi, W, Yang, D, Kang, J, Lim, T, Right Ventricular Functions Measured by Cardiac Magnetic Resonance Imaging in Patients who underwent Tricuspid Valvular Surgery: Implication for Patients Outcome.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018769.html