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Article: Changes in left ventricular function after mitral valve repair for severe organic mitral regurgitation

TitleChanges in left ventricular function after mitral valve repair for severe organic mitral regurgitation
Authors
Issue Date2012
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur
Citation
The Annals of Thoracic Surgery, 2012, v. 93 n. 3, p. 754-760 How to Cite?
AbstractBACKGROUND: Limited data are available on the changes in left ventricular (LV) contractile function at long-term follow-up after mitral valve repair (MVr). Moreover, assessment of LV systolic function in patients undergoing MVr is troublesome with current methods, given that mitral regurgitation is characterized by increased preload and decreased afterload, potentially masking LV dysfunction. The aim of this study was to assess the value of LV global strain (longitudinal and circumferential) measured by speckle tracking analysis for detecting changes in contractile function after MVr. METHODS: A total of 122 patients with organic mitral regurgitation who underwent successful MVr at an early stage (LV ejection fraction>60%, LV end-systolic diameter<40 mm) were included. Echocardiography was performed at baseline and at short-term ( approximately 7 days) and long-term (1 to 3 years) follow-up after MVr. RESULTS: At baseline, LV ejection fraction and LV global strain were higher in patients than in 40 normal control individuals. By contrast, LV forward stroke volume was higher in control individuals than in patients. At short-term follow-up, a significant decrease in LV ejection fraction and LV global strain was noted as a consequence of changes in loading conditions. At long-term follow-up, LV ejection fraction and LV global strain improved significantly. Correction of LV strain for LV size showed a subtle impairment of myocardial contractility at baseline, which significantly improved over time after MVr, together with the improvement in LV forward stroke volume. CONCLUSIONS: Mitral valve repair for organic mitral regurgitation results in a significant increase in LV myocardial contractility as measured by LV global strain corrected by LV size. © 2012 The Society of Thoracic Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/164271
ISSN
2015 Impact Factor: 2.975
2015 SCImago Journal Rankings: 1.490
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWitkowski, TGen_US
dc.contributor.authorThomas, JDen_US
dc.contributor.authorDelgado, Ven_US
dc.contributor.authorVan Rijnsoever, Een_US
dc.contributor.authorNg, ACTen_US
dc.contributor.authorHoke, Uen_US
dc.contributor.authorEwe, SHen_US
dc.contributor.authorAuger, Den_US
dc.contributor.authorYiu, KHen_US
dc.contributor.authorHolman, ERen_US
dc.contributor.authorKlautz, RJMen_US
dc.contributor.authorSchalij, MJen_US
dc.contributor.authorBax, JJen_US
dc.contributor.authorMarsan, NAen_US
dc.date.accessioned2012-09-20T07:57:29Z-
dc.date.available2012-09-20T07:57:29Z-
dc.date.issued2012en_US
dc.identifier.citationThe Annals of Thoracic Surgery, 2012, v. 93 n. 3, p. 754-760en_US
dc.identifier.issn0003-4975-
dc.identifier.urihttp://hdl.handle.net/10722/164271-
dc.description.abstractBACKGROUND: Limited data are available on the changes in left ventricular (LV) contractile function at long-term follow-up after mitral valve repair (MVr). Moreover, assessment of LV systolic function in patients undergoing MVr is troublesome with current methods, given that mitral regurgitation is characterized by increased preload and decreased afterload, potentially masking LV dysfunction. The aim of this study was to assess the value of LV global strain (longitudinal and circumferential) measured by speckle tracking analysis for detecting changes in contractile function after MVr. METHODS: A total of 122 patients with organic mitral regurgitation who underwent successful MVr at an early stage (LV ejection fraction>60%, LV end-systolic diameter<40 mm) were included. Echocardiography was performed at baseline and at short-term ( approximately 7 days) and long-term (1 to 3 years) follow-up after MVr. RESULTS: At baseline, LV ejection fraction and LV global strain were higher in patients than in 40 normal control individuals. By contrast, LV forward stroke volume was higher in control individuals than in patients. At short-term follow-up, a significant decrease in LV ejection fraction and LV global strain was noted as a consequence of changes in loading conditions. At long-term follow-up, LV ejection fraction and LV global strain improved significantly. Correction of LV strain for LV size showed a subtle impairment of myocardial contractility at baseline, which significantly improved over time after MVr, together with the improvement in LV forward stroke volume. CONCLUSIONS: Mitral valve repair for organic mitral regurgitation results in a significant increase in LV myocardial contractility as measured by LV global strain corrected by LV size. © 2012 The Society of Thoracic Surgeons.-
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur-
dc.relation.ispartofThe Annals of Thoracic Surgeryen_US
dc.subject.meshFemale-
dc.subject.meshMitral valve insufficiency - physiopathology - surgery-
dc.subject.meshProspective studies-
dc.subject.meshSeverity of illness index-
dc.subject.meshVentricular function, left-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.titleChanges in left ventricular function after mitral valve repair for severe organic mitral regurgitationen_US
dc.typeArticleen_US
dc.identifier.emailYiu, KH: khkyiu@hku.hken_US
dc.identifier.emailMarsan, NA: n.ajmone@lumc.nl-
dc.identifier.authorityYiu, KH=rp01490en_US
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.athoracsur.2011.11.034-
dc.identifier.pmid22296981-
dc.identifier.scopuseid_2-s2.0-84863393135-
dc.identifier.hkuros205997en_US
dc.identifier.volume93en_US
dc.identifier.issue3-
dc.identifier.spage754en_US
dc.identifier.epage760en_US
dc.identifier.isiWOS:000300832700023-
dc.publisher.placeUnited States-

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