Table 3. Between-Groups Comparisons of Pre- and Postoperative Findings.
| Preoperative | 6-Month Postoperative | Change from Pre- to 6-Month Postoperative | ||||
|---|---|---|---|---|---|---|
| Variable | PVR Alone (N = 34) | PVR with RV Remodeling (N = 30) | PVR Alone (N = 32) | PVR with RV Remodeling (N = 28) | PVR Alone (N = 34) | PVR with RV Remodeling (N = 30) |
| Cardiac Magnetic Resonance | ||||||
| RV ejection fraction (%) | 46 ± 9 | 48 ± 7 | 44 ± 9 | 47 ± 8 | -2 ± 7 | -1 ± 7 |
| Pulmonary regurgitation (%) | 49 ± 12 | 50 ± 9 | 4 ± 5 | 6 ± 11 | -25 ± 24 | -31 ± 22 |
| RV end-diastolic volume index (ml/m2) | 199± 34 | 202 ± 41 | 126 ± 26 | 119 ± 25 | -68 ± 37 | -78 ± 46 |
| RV end-systolic volume index (ml/m2) | 108 ± 29 | 105 ± 29 | 72 ± 26 | 64 ± 21 | -33 ± 23 | -39 ± 26 |
| RV stroke volume (ml) | 153 ± 41 | 158 ± 37 | 91 ± 21 | 95 ± 25 | -57 ± 36 | -58 ±36 |
| RV mass-to-volume ratio (g/ml) | 0.22 ± 0.05 | 0.21 ± 0.04 | 0.25 ± 0.06 | 0.25 ± 0.05 | 0.03 ± 0.06 | 0.04 ± 0.05 |
| LV end-diastolic volume index (ml/m2) | 92 ± 16 | 85 ± 15 | 95 ± 16 | 92 ± 19 | 3 ± 11 | 6 ± 12 |
| LV end-systolic volume index (ml/m2) | 40 ± 12 | 36 ± 9 | 43 ± 13 | 39 ± 11 | 3 ± 8 | 2 ± 8 |
| LV stroke volume (ml) | 87 ± 21 | 81 ± 21 | 90 ± 20 | 91 ± 25 | 3 ± 13 | 9 ± 15 |
| LV ejection fraction (%) | 57 ± 8 | 58 ± 7 | 56 ± 7 | 58 ± 7 | -1 ± 5 | 0 ± 7 |
| LV mass-to-volume ratio (g/ml) | 0.66 ± 0.11 | 0.66 ± 0.13 | 0.64 ± 0.11 | 0.61 ± 0.11 | -0.01 ± 0.10 | -0.05 ± 0.11 |
| ECG | ||||||
| QRS duration (ms) | 161 (91 - 200) | 150 (82 - 182) | 161 (80 - 202) | 142 (82 - 190) | 0 (-20 - 49) | -1 (-24 - 16) |
| QRS dispersion (ms) | 21 (9 - 54) | 22 (9 - 49) | 23 (12 - 40) | 27 (17 - 40) | 0 (-32 - 15) | 0 (-32 - 14) |
| Heart rate-corrected QT interval (ms) | 450 (301 - 514) | 455 (370 - 523) | 461 (359 - 528) | 460 (381 - 558) | 0 (-96 - 162) | 4 (-84 - 70) |
| QT dispersion (ms) | 51 (17 - 200) | 51 (12 - 171) | 45 (22 - 178) | 62 (29 - 116) | 0 (-119 - 64) | 0 (-69 - 68) |
| JT interval (ms) | 264 (204 - 418) | 285 (213 - 351) | 254 (200 - 359) | 275 (125 - 333) | 0 (-172 - 48) | 0 (-146 -56) |
| JT dispersion (ms) | 53 (13 - 195) | 55 (18 - 200) | 40 (27 - 172) | 60 (34 - 114) | 0 (-108 - 69) | 0 (-102 - 49) |
| Exercise test | ||||||
| Peak VO2 (ml/kg/min) | 27.1 (7.8 - 47.2) | 26.5 (9.8 - 41.4) | 27.0 (9.7 - 47.7) | 27.4 (10 - 43.9) | 0.0 (-8.6 - 6.1) | 0.0 (-10.6 - 8.7) |
| % predicted peak VO2 (%) | 66 (26 - 93) | 62 (42 - 101) | 69 (30 - 95) | 68 (41 - 95) | -1 (-11 - 18) | 1 (-25 - 25) |
| % predicted peak work rate | 71 (14 - 102) | 70 (34 - 106) | 77 (42 - 108) | 78 (30 - 122) | 0 (-8 - 27) | 1 (-9 - 25) |
| VAT (ml/kg/min) | 16.0 (8.0 - 28.8) | 14.5 (6.9 - 26.9) | 14.7 (7.1 - 21.9) | 15.4 (5.9 - 23.7) | 0.0 (-11.1 - 4.8) | 0.8 (-11.5 - 7.1) |
| % predicted VO2 at VAT | 39 (27 - 65) | 38 (22 - 58) | 37 (22 - 53) | 38 (23 - 56) | 0 (-24 - 14) | 1 (-23 - 18) |
| Peak heart rate (beats/min) | 165 (106 - 208) | 153 (87 - 193) | 168 (110 - 201) | 156 (100 - 194) | 0 (-31 - 35) | 1 (-67 - 103) |
| % predicted peak heart rate | 92 (65 - 111) | 83 (59 - 123) | 92 (68 - 109) | 89 (56 - 128) | 1 (-20 - 18) | 2 (-42 - 69) |
| Echocardiogram | ||||||
| ≤mild tricuspid regurgitation, % | 91 | 82 | 100 | 96 | † | ‡ |
| ≥moderate tricuspid regurgitation, % | 9 | 18 | 0 | 4 | † | ‡ |
| RV systolic pressure by tricuspid regurgitation (mm Hg) | 37 (20 - 76) | 30 (16 - 52) | 26 (20 - 57) | 25 (14 - 56) | 0 (-38 - 3) | 0 (-21 - 11) |
| RVOT gradient (mm Hg) | 20 (3 - 70) | 13 (3 - 45) | 12 (6 - 34) | 15 (6 - 40) | -2 (-60 - 24) | 0 (-12 - 8) |
| Functional status | ||||||
| SF-36 physical component | 48.7 ± 9.1 | 49.9 ± 7.3 | 53.6 ± 7.1 | 56.0 ± 2.6 | 5 ± 9 | 6 ± 6 |
| SF-36 mental component | 50.0 ± 7.7 | 49.1 ± 11.4 | 53.7 ± 6.8 | 55.4 ± 7.7 | 3 ± 6 | 6 ± 10 |
| CHQ-PF50 physical component | 43.2 ± 13.9 | 41.2 ± 14.6 | 50.4 ± 9.7 | 52.4 ± 4.6 | 7 ± 11 | 10 ± 14 |
| CHQ-PF50 mental component | 49.8 ± 10.2 | 49.6 ± 7.0 | 50.0 ± 10.5 | 54.5 ± 4.5 | 0 ± 9 | 4 ± 4 |
Data presented as median (range) or mean ± SD, as appropriate. Changes from pre- to 6-month postoperative were calculated carrying forward baseline values of those who failed to return for 6-month follow-up
†
In the PVR alone group, 4 patients decreased from ≥ moderate regurgitation to ≤ mild regurgitation
‡
In the PVR with RV remodeling group, 3 patients decreased from ≥ moderate regurgitation to ≤ mild regurgitation.
VAT= ventilatory anaerobic threshold; VO2= oxygen consumption