Reverse Remodeling of Tricuspid Valve Morphology and Function in Chronic Thromboembolic Pulmonary Hypertension Patients Following Pulmonary Thromboendarterectomy – A Cardiac Magnetic Resonance Imaging and Invasive Hemodynamic Study

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Abstract
BackgroundTo investigate changes in tricuspid annulus (TA) and tricuspid valve (TV) morphology among chronic thromboembolic pulmonary hypertension (CTEPH) patients before and 12 months after pulmonary thromboendarterectomy (PEA) and compare these findings to normal control subjects. Methods20 CTEPH patients and 20 controls were enrolled in the study. The patients were examined with echocardiography, right heart catherization and cardiac magnetic resonance imaging prior to PEA and 12 months after.ResultsRight atrium (RA) volume was significantly reduced from baseline to 12 months after PEA (30 ±9 versus 23 ±5ml/m2, pConclusionsIn CTEPH patients selected for PEA, TV tenting height, volume and valve area are significantly increased whereas annulus size and shape are less affected. The alterations in TV morphology are fully reversed after PEA and correlates to improvements of right ventricular-pulmonary arterial coupling.