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Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease  Ying Ye, BS, Ravi Desai, MD, Lina.

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Presentation on theme: "Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease  Ying Ye, BS, Ravi Desai, MD, Lina."— Presentation transcript:

1 Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease  Ying Ye, BS, Ravi Desai, MD, Lina M. Vargas Abello, MD, Jeevanantham Rajeswaran, PhD, Allan L. Klein, MD, Eugene H. Blackstone, MD, Gösta B. Pettersson, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 148, Issue 5, Pages e8 (November 2014) DOI: /j.jtcvs Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Relationship of preoperative risk factors to 5-year survival after mitral valve surgery with or without concomitant TV repair. A, Preoperative RV MPI. Solid line represents point estimates enclosed within a 68% confidence band for an individual with left ventricular end-systolic volume index = 25 mL·m−2, no complete heart block/pacer, left atrial diameter = 4.2 to 4.7 cm, mitral valve repair, no history of smoking, BUN = 20 mg·dL−1, and aortic clamp time = 72 minutes. B, Preoperative BUN. Depiction is as in (A) except that MPI has been set at BUN, Blood urea nitrogen; MPI, myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Instantaneous risk of death and postoperative TAPSE. Orange dashed line depicts the temporal trend of postoperative TAPSE. Blue solid line represents parametric estimate of risk of death. (Note expansion of early deaths compared with Figure E3, A.) TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

4 Appendix Figure E1 Interobserver correlation for TAPSE. A, Scatter plot. Black line represents linear trend of correlation between TAPSE measurements made by observers 1 and 5. B, Bland–Altman plot for TAPSE measurements made by observers 1 and 5. TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

5 Appendix Figure E2 Interobserver correlation for MPI. A, Scatter plot. Black line represents linear trend of correlation between MPI measurements made by observers 1 and 5. B, Bland–Altman plot for MPI measurements made by observers 1 and 5. MPI, Myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

6 Appendix Figure E3 Intraobserver correlation for TAPSE. A, Scatter plot. Black line represents linear trend of correlation between TAPSE measurements made by observer 1 on 2 different occasions. B, Bland–Altman plot for TAPSE measurements made by observer 1 on 2 different occasions. TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

7 Appendix Figure E4 Intraobserver correlation for MPI. A, Scatter plot. Black line represents linear trend of correlation between MPI measurements made by observer 1 on 2 different occasions. B, Bland–Altman plot for MPI measurements made by observer 1 on 2 different occasions. MPI, Myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

8 Figure E1 Number of patients with echocardiographic measurements available at and beyond various time points, and number of echocardiographic measurements available for analysis. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

9 Figure E2 Percentage of preoperative echocardiograms (781 total) with nonmissing values for indicated variables. MPI, Myocardial performance index; RA, right atrial; RV, right ventricular; RVOT, right ventricular outflow tract; TAPSE, tricuspid annular plane systolic excursion; TR, tricuspid regurgitation; TV, tricuspid valve. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

10 Figure E3 Mean TAPSE over time. Solid line represents unadjusted estimates of temporal trend of the mean response of postoperative TAPSE. Symbols represent data grouped (without regard to repeated measurements) within time frame to provide a crude verification of model fit. TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

11 Figure E4 Mean MPI over time. Solid line represents unadjusted estimates of temporal trend of the mean response of postoperative MPI. Symbols represent data grouped (without regard to repeated measurements) within time frame to provide a crude verification of model fit. MPI, Myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

12 Figure E5 Prevalence of TR grades over time after mitral valve surgery with or without concomitant TV repair. Depiction is as in Figure E4. Solid line represents unadjusted estimates of temporal trend of the prevalence of postoperative TR grades. Symbols represent data grouped (without regard to repeated measurements) within time frame to provide a crude verification of model fit. TR, Tricuspid regurgitation. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

13 Figure E6 Death after mitral valve surgery. A, Instantaneous risk of death (hazard function) enclosed within a 68% confidence band equivalent to ±1 standard error. B, Survival. Each circle represents a death, vertical bars represent 68% confidence limits equivalent to ±1 standard error, and numbers in parentheses represent number of patients traced beyond that point. Solid line enclosed within a dashed 68% confidence band represents parametric survival estimates. The Journal of Thoracic and Cardiovascular Surgery  , e8DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

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