Long-term echocardiographic changes in left ventricular size and function following surgery for severe mitral regurgitation

Puneet Ghayal, Ali Haider, Wilbert S. Aronow, Ythan Goldberg, Ricardo Bello, Mario J. Garcia, Daniel M. Spevack

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Chronic mitral regurgitation (MR) results in a state of chronic left ventricular (LV) volume overload, resulting in compensatory dilatation. Mitral valve (MV) surgery for regurgitation reduces LV preload but increases LV afterload. Few data are available documenting subsequent changes in LV size and function over time following MV surgery for severe regurgitation in unselected populations. Material/Methods: Pre- and postoperative echocardiograms (n=454) acquired from 108 consecutive patients with chronic MR who underwent MV surgery were analyzed. Results: LV diastolic diameter was 4 mm smaller on postoperative compared to preoperative exams, whereas LV fractional shortening (FS) was unchanged. Linear regression analysis showed no change in LV diastolic diameter over time postoperatively, whereas LV FS increased over time following surgery. Improvement in LV FS occurred at an average rate of 1.6% per year (95% CI, 0.2-2.9). Subgroups were small, but the same secular trends were generally noted in groups with or without coronary artery bypass graft surgery (CABGS) and in those with or without mitral leaflet disease. Conclusions: Following MV surgery for MR, LV diastolic diameter reduces by 2 mm at the time of surgery, but then remains stable over time. Improvement in LV function over time postoperatively was only seen in those without concomitant CABGS, possibly related to less baseline myocardial scarring in this group.

Original languageEnglish (US)
JournalMedical Science Monitor
Volume18
Issue number4
StatePublished - 2012

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Mitral Valve Insufficiency
Left Ventricular Function
Mitral Valve
Coronary Artery Bypass
Transplants
Cicatrix
Dilatation
Linear Models
Regression Analysis
Population

Keywords

  • Coronary artery bypass surgery
  • Echocardiography
  • Left ventricular diastolic diameter
  • Left ventricular fractional shortening
  • Mitral regurgitation
  • Mitral valve surgery

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Long-term echocardiographic changes in left ventricular size and function following surgery for severe mitral regurgitation. / Ghayal, Puneet; Haider, Ali; Aronow, Wilbert S.; Goldberg, Ythan; Bello, Ricardo; Garcia, Mario J.; Spevack, Daniel M.

In: Medical Science Monitor, Vol. 18, No. 4, 2012.

Research output: Contribution to journalArticle

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abstract = "Background: Chronic mitral regurgitation (MR) results in a state of chronic left ventricular (LV) volume overload, resulting in compensatory dilatation. Mitral valve (MV) surgery for regurgitation reduces LV preload but increases LV afterload. Few data are available documenting subsequent changes in LV size and function over time following MV surgery for severe regurgitation in unselected populations. Material/Methods: Pre- and postoperative echocardiograms (n=454) acquired from 108 consecutive patients with chronic MR who underwent MV surgery were analyzed. Results: LV diastolic diameter was 4 mm smaller on postoperative compared to preoperative exams, whereas LV fractional shortening (FS) was unchanged. Linear regression analysis showed no change in LV diastolic diameter over time postoperatively, whereas LV FS increased over time following surgery. Improvement in LV FS occurred at an average rate of 1.6{\%} per year (95{\%} CI, 0.2-2.9). Subgroups were small, but the same secular trends were generally noted in groups with or without coronary artery bypass graft surgery (CABGS) and in those with or without mitral leaflet disease. Conclusions: Following MV surgery for MR, LV diastolic diameter reduces by 2 mm at the time of surgery, but then remains stable over time. Improvement in LV function over time postoperatively was only seen in those without concomitant CABGS, possibly related to less baseline myocardial scarring in this group.",
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T1 - Long-term echocardiographic changes in left ventricular size and function following surgery for severe mitral regurgitation

AU - Ghayal, Puneet

AU - Haider, Ali

AU - Aronow, Wilbert S.

AU - Goldberg, Ythan

AU - Bello, Ricardo

AU - Garcia, Mario J.

AU - Spevack, Daniel M.

PY - 2012

Y1 - 2012

N2 - Background: Chronic mitral regurgitation (MR) results in a state of chronic left ventricular (LV) volume overload, resulting in compensatory dilatation. Mitral valve (MV) surgery for regurgitation reduces LV preload but increases LV afterload. Few data are available documenting subsequent changes in LV size and function over time following MV surgery for severe regurgitation in unselected populations. Material/Methods: Pre- and postoperative echocardiograms (n=454) acquired from 108 consecutive patients with chronic MR who underwent MV surgery were analyzed. Results: LV diastolic diameter was 4 mm smaller on postoperative compared to preoperative exams, whereas LV fractional shortening (FS) was unchanged. Linear regression analysis showed no change in LV diastolic diameter over time postoperatively, whereas LV FS increased over time following surgery. Improvement in LV FS occurred at an average rate of 1.6% per year (95% CI, 0.2-2.9). Subgroups were small, but the same secular trends were generally noted in groups with or without coronary artery bypass graft surgery (CABGS) and in those with or without mitral leaflet disease. Conclusions: Following MV surgery for MR, LV diastolic diameter reduces by 2 mm at the time of surgery, but then remains stable over time. Improvement in LV function over time postoperatively was only seen in those without concomitant CABGS, possibly related to less baseline myocardial scarring in this group.

AB - Background: Chronic mitral regurgitation (MR) results in a state of chronic left ventricular (LV) volume overload, resulting in compensatory dilatation. Mitral valve (MV) surgery for regurgitation reduces LV preload but increases LV afterload. Few data are available documenting subsequent changes in LV size and function over time following MV surgery for severe regurgitation in unselected populations. Material/Methods: Pre- and postoperative echocardiograms (n=454) acquired from 108 consecutive patients with chronic MR who underwent MV surgery were analyzed. Results: LV diastolic diameter was 4 mm smaller on postoperative compared to preoperative exams, whereas LV fractional shortening (FS) was unchanged. Linear regression analysis showed no change in LV diastolic diameter over time postoperatively, whereas LV FS increased over time following surgery. Improvement in LV FS occurred at an average rate of 1.6% per year (95% CI, 0.2-2.9). Subgroups were small, but the same secular trends were generally noted in groups with or without coronary artery bypass graft surgery (CABGS) and in those with or without mitral leaflet disease. Conclusions: Following MV surgery for MR, LV diastolic diameter reduces by 2 mm at the time of surgery, but then remains stable over time. Improvement in LV function over time postoperatively was only seen in those without concomitant CABGS, possibly related to less baseline myocardial scarring in this group.

KW - Coronary artery bypass surgery

KW - Echocardiography

KW - Left ventricular diastolic diameter

KW - Left ventricular fractional shortening

KW - Mitral regurgitation

KW - Mitral valve surgery

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