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].