Right chambers deformation after tricuspid edge-to-edge percutaneous repair

Abstract Background The development of new analysis software has allowed to broaden myocardial deformation study to right chambers. There are already reference values for right ventricle (RV) and more recently for right atrium (RA). Tricuspid edge-to-edge repair (TEER) potentially causes changes in right chambers mechanics. Purpose Our aim is to evaluate the impact of TEER in the myocardial deformation of RV and RA. Methods Observational retrospective study including all the consecutive patients undergoing TEER in our tertiary centre. Additionally, a control group of healthy volunteers was included. Baseline and 3 months postprocedural echocardiograms were analyzed with a dedicated software to obtain RV, free wall (FW-) and 4 chambers (4C-) global longitudinal strain (GLS), and RA, reservoir (SrRA), conduit (ScdRA) and centrality (SctRA) strains , deformation values. Interobserver variability was evaluated in the control group with the intraclass correlation coefficient (ICC). Differences in baseline values between cases and control group were evaluated with Mann-Whitney U test. Evolutive changes in deformation parameters were studied using paired Wilcoxon W test. Results 15 healthy controls and 29 patients undergoing TEER (79.3% female, 79 [75-82] years-old) were included. Baseline tricuspid regurgitation (TR) was severe in 21 (72.4%), whereas the others were massive or torrential, and the most frequent mechanism was functional (22, 75,9%). Interobserver agreement in the control group was excellent for FW-GLS (0.88; p <0.001), SrRA (0.99; p <0.001) y ScdRA (0.93; p <0.001), good for SctRA (0.68; p= 0.019) and insufficient for 4C-SGL (0.36; p= 0.20). RV deformation values were significantly worse in patients than in controls (Table). However, solely FW-GLS showed improvement 3 months after the procedure (-15.7 vs -20.5 %; p= 0.022). Conclusions Right chamber deformation analysis is feasible and significantly reduced in patients undergoing TEER. Nevertheless, percutaneous treatment of TR has scarce effect in mechanics at early phases. Longer follow up may be required to evaluate the impact in right strain parameters. Table. Right chambers myocardial deformation values in healthy controls and patients undergoing TEER.Figure