Search Results (10,262)

Background/Objectives: The purpose of this study was to investigate the association between HER-2 expression and clinicopathological characteristics, biochemical recurrence (BCR) rate, and BCR-free survival in localized prostate cancer (PCa) patients after radical prostatectomy (RP). Methods: Between January 2018 and December 2019, 44 patients with pathologically confirmed localized PCa who underwent RP were included in this study. According to the expressed level of HER-2 protein, patients were divided into four cohorts: cohort-1 (HER-2 0), cohort-2 (HER-2 1+ or 2+), cohort-3 (HER-2 0 or 1+), and cohort-4 (HER-2 2+); the clinicopathological and clinical outcomes were analyzed and compared between cohort-1 and cohort-2, and cohort-3 and cohort-4, respectively. Univariable and multivariable COX regression models and Kaplan–Meier curves were used to determine the association between HER-2 expression and clinicopathological outcomes, including Gleason score (GS), pathological T (pT) stage, positive surgical margins (PSM), and BCR-free survival, respectively. Results: The median follow-up time was 43 months (IQR 35–49). Among the 44 patients, 20 (45.5%) exhibited HER-2 immuno-reactivity, including 14 (31.8%) with HER-2 1+, 6 (13.64%) with HER-2 2+, and 0 (0%) with HER-2 3+ staining. The proportion of patients with PSM was significantly lower in the HER-2 0 group than in those with HER-2 1+ or 2+ (25.0% vs. 65.0%, p = 0.008). Multivariable logistics regression models revealed that HER-2 1+ or 2+ was an independent risk factor that was strongly associated with a higher proportion of PSM (OR, 2.69; 95% CI, 0.62–11.71, p = 0.042). A total of 18 (40.9%) patients experienced BCR after surgery, including 6 (25%) in cohort-1 and 12 (60.0%) in cohort-2 (p = 0.019), as well as 13 (34.2%) in cohort-3 and 5 (83.3%) in cohort-4 (p = 0.023). Kaplan–Meier analysis showed that patients in cohort-1 (HER-2 0) had significantly longer BCR-free survival than those in cohort-2 (HER-2 1+ or 2+) (p < 0.001), and those in cohort-3 had longer BCR-free survival than those in cohort-4 (p < 0.001). Furthermore, patients with PSM showed significantly shorter BCR-free survival compared to those with patients with negative surgical margins (NSM) (p = 0.005). Multivariable Cox regression analysis revealed that HER-2 1+, 2+ (HR, 17.00; 95% CI, 1.38–210.22, p < 0.001), HER-2 2+ (HR, 2.85; 95% CI, 1.23–3.25, p = 0.004), and PSM (HR, 6.12; 95% CI, 3.08–11.72, p = 0.007) were all significant independent predictors of BCR following surgery. Conclusions: HER-2 expression is a common phenomenon in PCa; nearly half of the proportion of localized PCa had HER-2 1+ or 2+, but the cases that expressed HER-2 3+ were rare. Cases with HER-2 1+ or 2+ were more likely to develop BCR compared with HER-2 0. The HER-2 1+ or 2+ expression was closely associated with a higher incidence of PSM and was an independent predictor of shorter BCR-free survival in patients with localized prostate cancer after radical prostatectomy. Full article

Background & Objectives: Current guidelines recognize a subgroup of favorable intermediate-risk (FIR) ISUP grade group (GG) 2 prostate cancer (PCa) that may be eligible for active surveillance (AS). However, upgrading and upstaging to more aggressive disease are frequently observed. We aimed to identify risk factors for adverse pathology in this cohort to better define clinical scenarios where AS may need to be reconsidered. Methods: We retrospectively analyzed 170 patients diagnosed with ISUP GG2 PCa by multiparametric MRI (mpMRI)/TRUS fusion biopsy, all treated with radical prostatectomy (RP). Patients with FIR disease were evaluated for upstaging to ≥pT3 or upgrading to ISUP GG of ≥3 at RP. Multivariable logistic regression identified predictors of adverse pathology. Key Findings and Limitations: Among 170 FIR patients, median PSA was 5.6 ng/mL. Most had PI-RADS 4 (57%) or 5 (20%) lesions; 13% were diagnosed by systematic biopsy only. At RP, 28% showed adverse pathology, including 5 patients (2.9%) with lymph node metastases. Independent predictors were a PI-RADS Score of ≥4, PSA of >7 ng/mL, and clinical T-stage on digital rectal examination. Conclusions and Clinical Implications: Nearly 1/3 of FIR PCa patients were upstaged to high-risk PCa at RP. Based on these findings, AS in clinical practice should only be considered after thorough patient counseling and performed using a stringent follow-up and staging regimen to minimize the risk of further disease progression. A key limitation is the lack of the percentage of Gleason pattern 4. Full article

Objectives: Hip fractures associated with osteoporosis are indicative of high rates of both disability and mortality. The objective of this study was to analyze the risk factors for recurrent hip fractures following primary osteoporotic hip fracture surgery in older adult patients. Methods: A single-center, retrospective cohort study was conducted on 376 patients suffering from primary osteoporotic hip fractures from 1 January 2020 to 31 December 2021. Multivariate logistic regression was used to identify risk factors for recurrent hip fractures. Results: The study observed 376 patients over a period of three years. The incidence of recurrent hip fractures was 20.5% (77/376). Multiple logistic regression analysis revealed that age ≥ 85 years (odd ratios [OR] = 3.127, 95% confidence interval [CI] = 1.672–5.849, p < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 3.794, 95%CI = 1.747–8.236, p < 0.001), and Parkinson’s disease (PD) (OR = 2.744, 95%CI = 1.249–6.028, p = 0.012) were independent risk factors for recurrent hip fractures; antiosteoporosis drugs (OR = 0.243, 95%CI = 0.131–0.451, p < 0.001), duration of antiosteoporosis drug therapy (OR = 0.564, 95%CI = 0.283–0.830, p = 0.003) and serum albumin ≥ 35 g·L⁻¹ (OR = 0.413, 95%CI = 0.194–0.881, p = 0.022) were independent protective factors for recurrent hip fractures. The receiver operating characteristic (ROC) curve demonstrated that the AUC was 0.802, the sensitivity was 77.8%, and the specificity was 75.5%. A significantly higher three-year mortality rate was observed among patients with recurrent hip fractures (26.0% vs. 15.4%, p = 0.029). Conclusions: Older patients with advanced age, COPD and PD were at greater risk of recurrent hip fractures. Early nutrition intervention and antiosteoporosis drug therapy may decrease the incidence of recurrent hip fractures in older patients, thereby reducing mortality. Full article

Metabolic diseases such as obesity and related conditions have an inflammatory basis. Genetic and nutritional factors can influence the development of these diseases by altering the inflammatory state. This study aimed to analyse how the rs659366 (G/A) polymorphism in the UCP2 gene interacts with dietary capsaicin (CAP) consumption and affects inflammatory markers in Mexican adults. A cross-sectional, analytical study was conducted in 212 adult patients. The UCP2 rs659366 polymorphism was genotyped using an allelic discrimination assay. Dietary CAP intake was measured with a validated food frequency questionnaire. Multivariate linear regression analyses were performed for interaction analyses. The ancestral allele G accounted for 40.2% and the risk allele A accounted for 59.8% of samples. There was a significant interaction between CAP intake and the UCP2 rs659366 polymorphism for the inflammatory marker NLR (neutrophil-to-lymphocyte ratio) (p < 0.05). Among subjects with the G allele, higher CAP intake was associated with higher NLR scores (p < 0.001). Patients with the G allele of the UCP2 rs659366 polymorphism experienced increased inflammation with higher CAP intake. This finding highlights the need for future studies in personalised nutrition and could expand knowledge about the effects of CAP on obesity and inflammation. Full article

Background: Accurate prognostic assessment in lung cancer is challenging, especially in settings with limited access to molecular testing. Routine hematological markers may complement TNM staging in identifying high-risk patients. Methods: We retrospectively analyzed 304 patients with histologically confirmed lung cancer to evaluate the prognostic value of hematological and inflammatory markers in relation to tumor stage and ECOG performance status. Survival was estimated using Kaplan–Meier analysis and independent predictors were identified through Cox regression. Cluster analysis integrated hematological markers with tumor characteristics. Results: Most patients presented with advanced disease (61.2% T4; 57.1% metastatic). Early stages (≤IIC) were associated with nearly double the median overall survival compared with stages ≥IIIA (p = 0.001). Nodal involvement and metastases further stratified outcomes. Among hematological markers, anemia (Hb < 11.85 g/dL) and leukocytosis (WBC > 11.71 × 10⁹/L) predicted shorter survival and remained independent predictors in the multivariable Cox model (HR 1.70, p < 0.001; HR 1.54, p = 0.004), along with T4 stage (HR 1.47, p = 0.015). PLT count and fibrinogen were significant in univariate analysis but not after adjustment, while CRP and D-dimer showed no association. Cluster analysis identified two subgroups, with patients in Cluster 2 (T4 stage, anemia, leukocytosis) experiencing more than double the mortality risk compared with Cluster 1 (HR 2.33, p < 0.001). Conclusions: TNM stage remains the dominant prognostic factor in lung cancer. However, Hb and WBC count provide additional prognostic information, and cluster analysis may refine risk stratification by capturing clinically relevant heterogeneity. Full article

Objectives: Although angiopoietin-like 4 (ANGPTL4) is highly associated with glucose hemostasis and lipid metabolism, the relationships between the serum ANGPTL4 level, glucose status and hepatic steatosis remain unclear. Therefore, this study aimed to quantify the independent effects of glucose intolerance and hepatic steatosis on circulating ANGPTL4 concentrations. Methods: A total of 348 age- and sex-matched participants with normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and newly diagnosed diabetes (NDD) with or without hepatic steatosis were recruited for this cross-sectional study. Serum ANGPTL4 levels were measured, and multivariate linear regression analysis was used to evaluate the relationship between ANGPTL4, glycemic status and hepatic steatosis. Results: Compared with NGT, both IGT and NDD were associated with significantly higher serum ANGPTL4 concentrations, irrespective of hepatic steatosis status. Serum ANGPTL4 did not differ by the presence versus absence of hepatic steatosis. In multiple regression analysis, body mass index, homeostasis model assessment of insulin resistance, NGT vs. IGT, and NGT vs. NDD were independently associated with ANGPTL4 levels after adjustment for cardiovascular risk factors and adiponectin, whereas hepatic steatosis was not. Conclusions: Elevated serum ANGPTL4 concentrations were independently associated with prediabetes and diabetes, irrespective of hepatic steatosis. Full article

Background: Cardiac amyloidosis is more common than previously thought with an incidence of up to 15% in aortic stenosis and heart failure with preserved ejection fraction. Pacemaker need in these patients ranges from 9.5% to 20%; however, its prevalence and clinical relevance in patients with unexplained cardiac conduction defects remain unclear. Methods: This retrospective, single-center cohort study evaluated 1107 patients who underwent intracardiac device implantation for unexplained cardiac conduction defects between 2015 and 2024. Patients with secondary conduction defects or known cardiomyopathy were excluded. The prognostic value of the T-AMYLO score and associated red flag findings were assessed in relation to the composite primary endpoint: all-cause mortality, non-fatal myocardial infarction, and non-fatal stroke. Results: Over a median of 58 months for follow-up, 460 patients experienced a primary event, including 346 deaths. Higher event rates were observed in older males, those with atrioventricular block, and patients receiving single-lead ventricular devices. T-AMYLO score and the presence of red flag findings, particularly aortic valve disease, AV block, peripheral neuropathy, low voltages and increased septal thickness were significantly associated with adverse outcomes. Multivariate Cox regression identified elevated T-AMYLO score (HR: 1.06, p = 0.012), aortic valve disease (HR: 1.29, p = 0.016), and AV block (HR: 1.43, p = 0.009) as independent predictors of mortality. Survival analyses confirmed a stepwise decline in prognosis with an increasing T-AMYLO risk group and red flag burden (p < 0.001). Conclusion: These findings highlight the importance of incorporating T-AMYLO scoring and red flags assessment in patients with conduction defects to improve early detection of cardiac amyloidosis and guide risk stratification for outcomes. Full article

Background: International and national policies increasingly call for person-centred approaches in disability services, yet little is known about how support intensity needs influence the allocation of resources for individuals with intellectual and developmental disabilities (IDDs). In Italy, where integrated socio-health systems operate within a human rights framework, this quantitative study investigates how individual and contextual factors shape resource use in individualized support planning. Methods: We analyzed data from 1152 adults with IDDs enrolled in 23 service centres across 13 Italian regions. Case managers developed Individualized Support Plans (ISPs) informed by the Supports Intensity Scale and socio-ecological variables. Resource use was measured as weekly counts of adaptive skills training, community participation supports, habilitation services, prosthetics, and assistive technologies. We applied multivariate count models (Sarmanov–Lee) to capture the interdependence across support types. Results: Findings show that gender and level of intellectual functioning did not significantly affect resource allocation. However, individuals with the highest support intensity needs often received fewer supports, particularly in adaptive skills and community participation. Residential settings were associated with higher levels of support provision compared to family or independent living. Assistive technologies and prosthetics were linked with more comprehensive support packages. Conclusions: While person-centred planning frameworks are being implemented, systemic inequities remain, with those at the highest levels of need at risk of receiving fewer enabling supports. Multivariate modelling provides a robust tool for understanding resource use and highlights the importance of equity-focused planning. These findings support policy and practice reforms that operationalize human rights principles and align with the UNCRPD, ensuring more inclusive and responsive systems of support. Full article

Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) is a widely accepted method for long-term enteral nutrition, but procedure-related complications and early mortality remain major concerns. Nutritional and inflammatory indices such as serum albumin, C-reactive protein (CRP), Prognostic Nutritional Index (PNI), and Nutrition Risk Screening (NRS-2002) may provide prognostic value, yet comparative data in PEG cohorts are limited. This study aimed to identify predictors of complications and 90-day mortality after PEG and to compare the prognostic performance of nutritional indices. Materials and Methods: A retrospective cohort of 122 consecutive adult patients undergoing PEG between January and December 2024 was analyzed. Demographic, clinical, and laboratory parameters were collected, including albumin, CRP, PNI, and NRS-2002. Complications were categorized as early (≤30 days) or late (>30 days), and all-cause mortality was assessed at 30 and 90 days. Univariate and multivariate logistic regression models were used to evaluate predictors of complications and 90-day mortality. To address multicollinearity, albumin, PNI, and NRS-2002 were separately tested in adjusted models, with model performance assessed by AIC, BIC, Nagelkerke R², and C-index. Results: Early complications occurred in 4.9% and late complications in 8.2% of patients, for a total complication rate of 13.1%. Thirty-day mortality was 4.1%, 90-day mortality 17.2%, and total in-hospital mortality during the study year 30.3%. Neuromuscular indication was independently associated with increased risk of complications (aOR 5.0, 95% CI 1.2–20.0, p = 0.028) but reduced 90-day mortality (aOR 0.15, 95% CI 0.03–0.80, p = 0.025). Lower baseline albumin independently predicted higher 90-day mortality (aOR 0.92, 95% CI 0.86–0.99, p = 0.034). Elevated CRP demonstrated a borderline association with mortality (p = 0.051), while NRS-2002 ≥5 and Δ-PNI showed borderline trends toward increased mortality risk. In model comparison, none of the nutritional indices achieved independent statistical significance, but all demonstrated similar performance (AIC = 114, C-index 0.72–0.74). Conclusions: PEG outcomes are strongly influenced by baseline indication and nutritional–inflammatory status. Neuromuscular patients and patients with dysphagia face higher complication risk but lower short-term mortality, while hypoalbuminemia, elevated CRP, and high NRS-2002 or declining PNI identify patients at greater risk of death. Systematic integration of albumin, CRP, PNI, and NRS-2002 may improve risk stratification and management in PEG candidates. Full article

Background/Objectives: Dynapenia, characterized by an age-related decline in muscle strength, has recently gained attention as a major public health concern. While prior studies identified individual risk factors, little is known about how these factors cluster differently by sex. This study investigated sex-specific risk factors and their combinations associated with dynapenia among Korean middle-aged and older adults. Methods: We analyzed 22,850 participants aged ≥ 40 years from the 2014–2019 Korea National Health and Nutrition Examination Survey. Dynapenia was defined as handgrip strength < 28 kg in men and <18 kg in women. Sex-stratified multivariable logistic regression identified independent predictors, and association rule mining (ARM) detected synergistic risk factor combinations. Results: Dynapenia was more prevalent in women (13.9%) than in men (8.5%). Advancing age, physical inactivity, lack of resistance exercise, and a high incidence of diabetes and stroke were consistent risk factors in both sexes. However, ARM revealed distinct clustering patterns: behavioral factors predominated in men, whereas socioeconomic disadvantage and metabolic comorbidities were more relevant in women with dynapenia. Conclusions: These findings emphasize the need for sex-specific prevention strategies for dynapenia, promoting resistance exercise among men and addressing both inactivity and socioeconomic barriers in women. Full article

Background: Prostate cancer is the most frequent malignancy in men, with an incidence of 21% of all diagnosed tumors in this population in Spain. Between 10 and 20% of patients with prostate cancer develop castration-resistant prostate cancer (CRPC). Abiraterone is widely used in CRPC and metastatic prostate cancer, but data on its renal safety are limited. Methods: We performed a single-center, retrospective observational study including patients with advanced prostate cancer who initiated abiraterone between January 2013 and July 2024 at Hospital Clínico San Carlos (Madrid, Spain). Patients were followed until December 2024. Renal events were defined as acute kidney injury (AKI), electrolyte imbalance, new onset or worsening hypertension (HTN), and/or volume overload. Risk factors and associations with mortality were analyzed using multivariate models. Results: Seventy-nine patients were included (mean age 76 ± 9.5 years; 70.9% CRPC; 89.9% metastatic disease). Median follow-up was 17 months. Renal events occurred in 63.3% of patients. Independent risk factors were metastatic disease (OR 13.335; 95% CI 1.418–124.444; p < 0.0235) and HTN (OR 3.336; 95% CI 1.091–10.206; p < 0.0347). Electrolyte imbalance occurred in 36.7% of patients. AKI developed in 30.4% of patients, of whom 50% progressed to chronic kidney disease. New/worsening HTN occurred in 25.5%, and volume overload occurred in 16.5%. Abiraterone discontinuation due to renal events was rare (4%). At the end of follow-up, 18.9% of patients had died. In a multivariate Cox analysis, AKI was identified as an independent predictor of mortality [HR 3.044 (95% CI 1.001–9.260); p = 0.05]. Conclusions: Renal events are common in patients treated with abiraterone, especially in those with metastatic disease and hypertension. AKI independently predicted mortality. Close monitoring of renal function and blood pressure is essential in this population. Full article

Background/Objectives: Psychiatric morbidity is frequent in oncology, yet prevalence and correlates differ across tumour sites. Urogenital cancers, in particular, involve psychosocial stressors related to sexuality, fertility, continence, and body image, which may intensify anxiety and depression. This study aimed to estimate the proportion of psychiatric morbidity among psychiatry-assessed oncology inpatients in a real-world hospital setting to compare urogenital with non-urogenital malignancies and to examine clinical correlates and hospitalisation outcomes. Methods: We conducted a retrospective analysis of 174 oncology inpatients who were evaluated by liaison psychiatry and completed the Hospital Anxiety and Depression Scale (HADS) during admission to a tertiary hospital in Galați, Romania, between 2019 and 2022. All patients completed the Hospital Anxiety and Depression Scale (HADS) and underwent liaison psychiatry evaluation. Mixed anxiety–depressive disorder (ICD-10 F41.2) was the primary psychiatric outcome. Demographic, clinical, and functional data—including Eastern Cooperative Oncology Group (ECOG) performance status—were extracted from medical records. Comparative and multivariable analyses were performed to identify predictors of severe depressive symptoms (primary outcome, HADS-D ≥ 11) and to explore associations with length of stay and costs. Results: Overall, 59% of patients had elevated HADS-Anxiety and 62% elevated HADS-Depression, while 40% received a psychiatric diagnosis. Mixed anxiety–depressive disorder predominated, especially in cervical (95%), bladder (100%), and prostate (≈70–75%) cancers. Urogenital cancers showed significantly higher rates of anxiety/depression than non-urogenital cancers (85% vs. 46%, p < 0.01). Poorer ECOG status independently predicted severe depressive symptoms (OR 3.6, 95% CI 2.1–6.2, p < 0.001). Psychiatric morbidity was associated with a trend toward longer LOS (median 12 vs. 9 days, p ≈ 0.08) and ≈10% higher hospital costs. Conclusions: Anxiety and depression were highly frequent among psychiatry-assessed oncology inpatients, particularly in urogenital malignancies. Functional impairment strongly correlates with psychiatric morbidity. These findings underscore the need for systematic screening and risk-stratified psycho-oncologic interventions to improve patient outcomes and resource utilisation. Full article

Background: Prediabetes is a significant precursor to type 2 diabetes mellitus (T2DM) and its well-known complications. In Sudan, data on the epidemiology of prediabetes among adolescents are scarce, especially in the central region. Thus, this study aimed to determine the prevalence of and factors associated with prediabetes among adolescents in central Sudan. Methods: This community-based cross-sectional study was carried out in East Gezira, central Sudan, from April to June 2025 and included 379 adolescents. Sociodemographic characteristics, anthropometric data (body mass index and BMI-z-score), and clinical information were gathered. Prediabetes was defined as a glycated hemoglobin (HbA1c) level in the range of 5.7% to 6.4%. Multivariate binary analysis was applied to identify the factors associated with prediabetes. Results: The median (interquartile range, IQR) age and BMI-z-score of the 379 enrolled adolescents were 14 (12–16) years and −1.4 (−2.1–−0.39), respectively. Sixty-four (17.0%) adolescents had prediabetes. Univariate analysis did not reveal any significant associations between the investigated factors and prediabetes. However, multivariate binary analysis showed that being female was independently associated with prediabetes among adolescents (adjusted odds ratio, AOR = 1.80, 95% confidence interval, CI 1.01–3.18). Age, BMI z-score, parent education, and occupation were not associated with prediabetes. Conclusions: The prevalence of prediabetes among adolescents in central Sudan is substantial, highlighting a potential future surge in T2DM. The finding that female adolescents are at a higher risk underscores the need for targeted, gender-sensitive screening and preventive health programs to mitigate the progression from prediabetes to T2DM. Full article

Background: Epithelial ovarian cancer is an aggressive malignancy with poor prognosis despite advances in multimodal treatment. The systemic immune-inflammation index (SII) has emerged as a prognostic biomarker in various cancers; however, the impact of surgery-induced inflammatory changes remains unclear. Methods: This study evaluated the prognostic significance of postoperative changes in SII among patients with epithelial ovarian cancer undergoing primary surgery. Data from 374 patients treated at Samsung Medical Center and Kangbuk Samsung Hospital between 2016 and 2021 were retrospectively reviewed. SII was calculated from complete blood counts obtained within one month before surgery and on postoperative day 1. The percentage change in SII was analyzed, and the optimal cutoff was determined using receiver operating characteristic curve analysis. Survival outcomes were assessed using Kaplan–Meier and multivariable Cox regression models. Results: Patients with a postoperative SII increase > 98.4% (Group 2) had significantly poorer overall (HR = 1.86, p = 0.009) and progression-free survival (HR = 1.30, p = 0.112) compared with those with smaller changes (Group 1). Discussion: High-grade histology, serous subtype, and greater intraoperative blood loss were associated with higher postoperative SII. A marked postoperative increase in SII independently predicted poor survival, suggesting that dynamic inflammatory responses rather than static baseline levels provide additional prognostic information. Conclusions: Perioperative SII monitoring, easily obtainable from routine blood tests, may help identify high-risk patients who could benefit from intensified surveillance or adjuvant treatment. Prospective multicenter studies are warranted to validate these findings and explore whether perioperative modulation of systemic inflammation can improve outcomes. Full article

Objectives: The purpose of this study was to determine whether concomitant tricuspid valve repair (TVr) at the time of left ventricular assist device (LVAD) implantation improves outcomes in patients with ≥moderate tricuspid regurgitation (TR) and to evaluate the prognostic value of preoperative right ventricular (RV) strain. Methods: In a retrospective analysis of 100 LVAD recipients (44 TVr; 56 No-TVr), preoperative (preop) and postoperative (postop) clinical, echocardiographic, and hemodynamic variables, including pulmonary vascular resistance (PVR) and pulmonary artery pulsatility index (PAPI), were analyzed. RV free wall strain (RV-FWS) and RV fractional area change (RV-FAC) were measured by speckle tracking. Early right heart failure (RHF) was modeled with multivariable logistic regression, and 2-year mortality was assessed with Fine–Gray competing risk regression. Preoperative and three-month measurements were compared within each of the 100 patients. Results: Baseline invasive hemodynamics, RV-FWS, and RV-FAC were similar between the TVr and No-TVr groups. TVr at the time of LVAD implantation reduced postoperative TR grade, but it did not improve RV-FWS or RV-FAC at 3 months. The No-TVr patients were more often discharged home and had lower 30-day readmissions. PVR was comparable preoperatively and at 3 months postoperatively. In adjusted analyses, preop PVR, PAPI, and TVr were not independently associated with early RHF, whereas decreased preoperative RV-FWS and lower preop RV-FAC independently predicted higher 2-year mortality. Conclusions: In LVAD recipients with ≥moderate TR, concomitant TVr lowers postoperative TR severity but does not improve early RHF, RV strain-based remodeling, or 2-year mortality. Preoperative RV deformation metrics, rather than preoperative PVR or PAPI, independently predict survival following LVAD implantation with or without TVr. Full article