Table 4. Effects of PVR on Key Outcomes in all Patients.
| Variable | Preoperative | 6-month Follow-Up | Change | P Value |
|---|---|---|---|---|
| NYHA class | ||||
| I | 34 (54) | 56 (92) | † | <0.001 |
| II | 23 (37) | 3 (5) | ||
| III | 5 (8) | 2 (3) | ||
| IV | 1 (2) | 0 (0) | ||
| Cardiac Magnetic Resonance | ||||
| RV ejection fraction (%) | 47 ± 8 | 45 ± 9 | -2 ± 7 | 0.07 |
| Pulmonary regurgitation (%) | 49 ± 11 | 5 ± 9 | -44 ± 12 | <0.001 |
| RV end-diastolic volume index (ml/m2) | 201 ± 37 | 123 ± 25 | -78 ± 38 | <0.001 |
| RV end-systolic volume index (ml/m2) | 107 ± 29 | 68 ± 24 | -39 ± 24 | <0.001 |
| RV stroke volume (ml) | 155 ± 39 | 93 ± 23 | -61 ± 33 | <0.001 |
| RV mass-to-volume ratio (g/ml) | 0.22 ± 0.04 | 0.25 ± 0.06 | 0.03 ± 0.06 | <0.001 |
| LV end-diastolic volume index (ml/m2) | 89 ± 15 | 94 ± 17 | 5 ± 12 | 0.002 |
| LV ejection fraction (%) | 58 ± 8 | 57 ±7 | -1 ± 6 | 0.52 |
| ECG | ||||
| QRS duration (ms) | 154 (82-200) | 150 (80-202) | -2 (-24 - 49) | 0.12 |
| QRS dispersion (ms) | 22 (9-54) | 23 (12 – 40) | 4 (-32 - 15) | 0.84 |
| QTc (ms) | 450 (301-523) | 460 (359-558) | 4 (-96 - 162) | 0.53 |
| JT interval (ms) | 274 (204-418) | 259 (125-359) | -5 (-172 - 56) | 0.05 |
| Exercise | ||||
| Peak VO2 (ml/kg/min) | 26.5 (7.8-47.2) | 27 (9.7-47.7) | 0 (-10 - 8.7) | 0.89 |
| % predicted peak VO2 (%) | 65 (26-101) | 68 (30-95) | 1 (-25 - 25) | 0.57 |
| % predicted VO2 at VAT | 38 (22-65) | 38 (22-56) | 0 (-24 - 18) | 0.86 |
| % predicted peak heart rate (%) | 88 (59-123) | 92 (56-128) | 2 (-42 - 69) | 0.23 |
| Echocardiogram | ||||
| ≥ moderate tricuspid regurgitation, n (%) | 8 (13) | 1 (2) | ‡ | 0.02 |
| RV systolic pressure by tricuspid regurgitation (mm Hg) | 31 (16-76) | 25 (14-57) | -3 (-38 - 11) | 0.02 |
| RVOT gradient (mm Hg) | 16 (3-70) | 14 (6-40) | -4 (-60 - 24) | 0.04 |
| Functional status | ||||
| SF-36 physical component | 49.2 ± 8.3 | 54.6 ± 5.7 | 5 ± 8 | <0.001 |
| SF-36 mental component | 49.6 ± 9.4 | 54.4 ± 7.2 | 5 ± 8 | <0.001 |
| CHQ-PF50 physical component | 42.3 ± 13.9 | 51.3 ± 7.9 | 8 ± 12 | 0.002 |
| CHQ-PF50 mental component | 49.7 ± 8.8 | 51.9 ± 8.7 | 2 ± 7 | 0.29 |
VAT= ventilatory anaerobic threshold; VO2= oxygen consumption
†
24 patients had a decrease in NYHA class at 6-month follow-up relative to preoperative; no patients demonstrated increased NYHA class.
‡
7 patients with ≥ moderate tricuspid regurgitation preoperatively decreased to ≤ mild tricuspid regurgitation at the 6-month follow-up; no patients demonstrated increased tricuspid regurgitation grade.