영구형 심박동기 삽입 후 유의한 삼첨판 역류증 발생의 예측인자 (Predictors of the Development of Significant Tricuspid Regurgitation after Permanent Pacemaker Implantation)

서지정보

· 발행기관 : 대한내과학회
· 수록지 정보 : 대한내과학회지 / 86권 / 5호 / 577 ~ 584페이지
· 저자명 : 이경진, 김계훈, 임이랑, 박혁진, 이승헌, 김지은, 정형기, 윤현주, 윤남식, 홍영준, 박형욱, 김주한, 안영근, 정명호, 조정관, 박종춘

초록

Background/Aims: We sought to identify predictors of significant tricuspid regurgitation (TR) after successful permanentpacemaker (PPM) implantation in Korean patients.
Methods: Of 404 patients who underwent PPM implantation, 187 patients who had both baseline and follow-up echocardiographicexaminations were assigned to one of two groups: no development or change in TR (Group I, n = 172, 65.5 ± 13.7 years) versus thedevelopment of significant TR (Group II, n = 15, 72.1 ± 8.3 years). Clinical, laboratory, and echocardiographic variables werecompared between the two groups.
Results: Overall, the grade of TR was significantly aggravated from 0.46 ± 0.73 to 0.81 ± 0.84 (p < 0.001) during 3.1 ± 1.8 years offollow-up (0.49 ± 0.75 to 0.69 ± 0.74 in Group I, p < 0.001; 0.13 ± 0.35 to 2.27 ± 0.46 in Group II, p < 0.001). The de novodevelopment or aggravation of TR was observed in 66 patients (35.3%), and significant TR developed in 15 patients (8.0%). Thepresence of atrial fibrillation (AF) was significantly higher (53.3 vs. 18.6%, p = 0.002), and the implantation of a ventricle pacing,ventricle sensing, inhibited by ventricular event (VVI) type pacemaker was more frequent in Group II than in Group I (46.7 vs.
15.1%, p = 0.002). Other variables were not different between the groups.
Conclusions: The development or aggravation of TR was not rare after successful PPM implantation, even though the developmentof significant TR was uncommon. The presence of AF and the implantation of a VVI type pacemaker were predictors of thedevelopment of significant TR. Together, the results of this study suggest that the development or aggravation of TR should bemonitored carefully after PPM implantation.

영어초록

Background/Aims: We sought to identify predictors of significant tricuspid regurgitation (TR) after successful permanentpacemaker (PPM) implantation in Korean patients.
Methods: Of 404 patients who underwent PPM implantation, 187 patients who had both baseline and follow-up echocardiographicexaminations were assigned to one of two groups: no development or change in TR (Group I, n = 172, 65.5 ± 13.7 years) versus thedevelopment of significant TR (Group II, n = 15, 72.1 ± 8.3 years). Clinical, laboratory, and echocardiographic variables werecompared between the two groups.
Results: Overall, the grade of TR was significantly aggravated from 0.46 ± 0.73 to 0.81 ± 0.84 (p < 0.001) during 3.1 ± 1.8 years offollow-up (0.49 ± 0.75 to 0.69 ± 0.74 in Group I, p < 0.001; 0.13 ± 0.35 to 2.27 ± 0.46 in Group II, p < 0.001). The de novodevelopment or aggravation of TR was observed in 66 patients (35.3%), and significant TR developed in 15 patients (8.0%). Thepresence of atrial fibrillation (AF) was significantly higher (53.3 vs. 18.6%, p = 0.002), and the implantation of a ventricle pacing,ventricle sensing, inhibited by ventricular event (VVI) type pacemaker was more frequent in Group II than in Group I (46.7 vs.
15.1%, p = 0.002). Other variables were not different between the groups.
Conclusions: The development or aggravation of TR was not rare after successful PPM implantation, even though the developmentof significant TR was uncommon. The presence of AF and the implantation of a VVI type pacemaker were predictors of thedevelopment of significant TR. Together, the results of this study suggest that the development or aggravation of TR should bemonitored carefully after PPM implantation.

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