Features of Lead-Induced Tricuspid Regurgitation in Patients With Heart Failure Events After Cardiac Implantation of Electronic Devices ― A Three-Dimensional Echocardiographic Study ―

  • Nakajima Hideki
    Clinical Laboratory, University of Tsukuba Hospital
  • Seo Yoshihiro
    Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
  • Ishizu Tomoko
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Iida Noriko
    Clinical Laboratory, University of Tsukuba Hospital
  • Sato Kimi
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Yamamoto Masayoshi
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Machino-Ohtsuka Tomoko
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Nogami Akihiko
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Ohte Nobuyuki
    Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
  • Ieda Masaki
    Department of Cardiology, Faculty of Medicine, University of Tsukuba

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抄録

<p>Background:Lead-induced tricuspid regurgitation (TR) after cardiac implantable electronic device (CIED) implantation is not fully understood. This study aimed to reveal the features of lead-induced TR by 3-dimensional echocardiography (3DE) in patients with heart failure (HF) events after CIED implantation.</p><p>Methods and Results:In 143 patients, 3DE assessments for the tricuspid valve (TV) and right ventricular morphologies were sequentially performed within 3 days after CIED implantations, during TR exacerbations, and at ≥6 months after TR exacerbations. TR exacerbations were observed in 29 patients (median 10 months after CIED implantation, range 1–28 months), 15 of whom had lead-induced TR. In the 29 patients, the tenting height of the TV, tricuspid annular (TA) height, and TA area at baseline were independent predictors for worsening TR. In patients with lead-induced TR, tenting height of the TV and TA area were identified as the risk factors. In addition, all patients with a lead positioned on a leaflet immediately after CIED implantations developed lead-induced TR. At follow up, TR exacerbation of lead-induced TR persisted with TA remodeling, but it was improved in the lead non-related-TR group.</p><p>Conclusions:TA remodeling at baseline and a lead location on a leaflet immediately after CIED implantation were associated with lead-induced TR in patients with HF events after CIED implantation. Persistent TA remodeling may make lead-induced TR refractory against HF treatments.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 84 (12), 2302-2311, 2020-11-25

    一般社団法人 日本循環器学会

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