Original articleAdult cardiacTissue Doppler Imaging Predicts Left Ventricular Reverse Remodeling After Surgery for Mitral Regurgitation
Section snippets
Patient Characteristics and Perioperative Management
After approval by the Institutional Review Board, we retrospectively reviewed prospectively entered, protocol-based, electronic medical records of 658 consecutive patients who underwent elective corrective surgery for chronic severe organic mitral regurgitation between November 2005 and December 2011 at the Cardiovascular Hospital of Yonsei University Health System. The need to obtain written consent from patients was waived by the Institutional Review Board. Patients with preoperative LVEF
Results
Postoperative follow-up echocardiography (mean 17 months) revealed recurrent moderate or greater mitral regurgitation in 4, 4, and 3 patients in each tertile, respectively. These patients were excluded from temporal comparisons of LVEF, LAVI, and LVMI.
Patient characteristics and operative data according to tertile distribution of the Sm are summarized in Table 1. Patients in the first tertile were older, had higher incidences of congestive heart failure and tricuspid regurgitation, and were
Comment
For severe organic mitral regurgitation, only development of symptom or signs of overt LV dysfunction (decreased EF and enlarged dimension) is suggested as a class I indication of surgery in the current guidelines 3, 13. However, with increasing evidence of disappointing postoperative outcomes in advanced cases 14, 15, efforts are ongoing to detect subclinical LV dysfunction so that surgery can be performed to prevent the irreversible LV deterioration. In this regard, one of the reasonable
References (25)
- et al.
Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications
J Am Coll Cardiol
(1994) - et al.
2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease)
J Am Coll Cardiol
(2008) - et al.
Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function
Am J Cardiol
(1996) - et al.
Relationship of ventricular longitudinal function to contractile reserve in patients with mitral regurgitation
Am Heart J
(2003) - et al.
Survival implication of left ventricular end-systolic diameter in mitral regurgitation due to flail leaflets a long-term follow-up multicenter study
J Am Coll Cardiol
(2009) - et al.
The role of left ventricular long axis contraction in patients with asymptomatic non-ischemic mitral valve regurgitation and normal systolic function
Int J Cardiol
(2008) - et al.
Does early surgical intervention improve left ventricular mass regression after mitral valve repair for leaflet prolapse?
J Thorac Cardiovasc Surg
(2011) - et al.
Determinants of survival and left ventricular performance after mitral valve replacement. Department of Veterans Affairs Cooperative Study on Valvular Heart Disease
Circulation
(1990) - et al.
Left ventricular response to mitral regurgitation: implications for management
Circulation
(2008) - et al.
Assessment of left ventricular long axis contraction can detect early myocardial dysfunction in asymptomatic patients with severe aortic regurgitation
Heart
(2001)
Peak systolic velocity of mitral annular longitudinal movement measured by pulsed tissue Doppler imaging as an index of global left ventricular contractility
Am J Physiol Heart Circ Physiol
Progressive nature of chronic mitral regurgitation and the role of tissue Doppler-derived indexes
Am J Physiol Heart Circ Physiol
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2015, Heart Lung and CirculationCitation Excerpt :TDI measurements are reported in varying cardiac conditions with validation as a marker of LV systolic dysfunction [9,10], diastolic dysfunction [8,11], LV dyssynchrony [12–14], right ventricular [15] and atrial function [16]. It is useful in the evaluation of coronary artery disease [17] and has prognostic implications [15,18–21]. Tissue Doppler imaging measurements are more sensitive than conventional echocardiography for detecting early myocardial alterations in primary myocardial (eg hypertrophic and dilated cardiomyopathies) and secondary myocardial disorders (eg ischaemia) [18,19,22–28].
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