Comparison of FTR Trajectories between Groups
According to relevant literature, FTR further deteriorates after left
heart valve surgery, which will reduce long-term survival and cardiac
function and reduce the quality of life of surviving patients even
without right heart insufficiency and severe
PH[11]. Postoperative FTR deterioration is the
result of multiple factors and the mechanism is complex. Currently, the
mechanism recognized by many scholars is: long-term left heart valve
lesions lead to left atrium enlargement, atrial muscle remodeling, and
changes in electrophysiological environment and mechanical activity of
cardiac cells, leading to AF eventually[12].
Persistent AF can make atrial mechanical loss cause hemodynamic changes,
in the left atrium formed eddy current to make it further expanded,
pulmonary vasoconstriction and refactoring to PH, right ventricular
myocardial irreversible damage occurs, three pointed leaf TA gradually
expand, in turn, lead to FTR, FTR deteriorating and will further
aggravate the AF, PH, etc., a vicious circle has been
formed[13]. A retrospective analysis of the
preoperative data of the three longitudinal trajectory groups showed
that with the increasing speed of FTR trajectory, the length of medical
history, LAD, complications of AF and PH, TRA, RATD, RALD, and LVEDD
also gradually increased, which could explain the mechanism of worsening
FTR. It was also further confirmed that there is an inseparable link
between the progression of FTR and left heart valve
disease[14].