Document Detail

Assessment of myocardial deformation: Predicting medium-term left ventricular dysfunction after surgery in patients with chronic mitral regurgitation.
MedLine Citation:
PMID:  20450848     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION AND OBJECTIVES: The development of left ventricular dysfunction after mitral valve replacement is a common problem in patients with chronic severe mitral regurgitation. Assessment of myocardial deformation enables myocardial contractility to be accurately estimated. Our aim was to compare the value of the preoperative strain and strain rate derived by either speckle-tracking echocardiography or tissue Doppler imaging (TDI) for predicting the medium-term decrease in left ventricular ejection fraction (LVEF) following surgery. METHODS: This prospective study involved 38 consecutive patients with chronic severe mitral regurgitation who were scheduled for mitral valve replacement. The longitudinal strain and strain rate in the interventricular septum were measured preoperatively using speckle-tracking echocardiography and TDI. The LVEF was determined preoperatively and postoperatively using 3-dimensional echocardiography. Echocardiographic assessments were performed in the 48 hours prior to surgery and 6 months postoperatively. RESULTS: The patients' mean age was 59.9+/-11.3 years and 10 (29.4%) were male. Both speckle-tracking echocardiography and TDI were found to be predictors of a >10% decrease in LVEF at 6 months. However, the predictive value of speckle-tracking echocardiography was greater than that of TDI. The longitudinal strain at baseline in the interventricular septum as measured by speckle-tracking echocardiography was the most powerful predictor; the area under the curve was 0.85 and the optimal cut-off value was -0.11. CONCLUSIONS: Speckle-tracking echocardiography can be used to predict a decrease in LVEF over the medium term after mitral valve replacement. Moreover, the predictive accuracy of speckle-tracking echocardiography was greater than that of TDI.
José A de Agustín; Leopoldo Pérez de Isla; Iván J Núñez-Gil; David Vivas; María del C Manzano; Pedro Marcos-Alberca; Covadonga Fernández-Golfín; Cecilia Corros; Carlos Almería; José L Rodrigo; Adalia Aubele; Dionisio Herrera; Enrique Rodríguez; Carlos Macaya; José Zamorano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista española de cardiología     Volume:  63     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-08-23     Revised Date:  2010-10-13    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  544-53     Citation Subset:  IM    
Instituto Cardiovascular, Hospital Clínico San Carlos, Spain.
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MeSH Terms
Cardiac Surgical Procedures
Chronic Disease
Echocardiography, Doppler
Heart Valve Prosthesis Implantation
Logistic Models
Middle Aged
Mitral Valve Insufficiency / surgery*
Myocardium / pathology*
Postoperative Complications / etiology*,  ultrasonography
Predictive Value of Tests
Prospective Studies
ROC Curve
Ventricular Dysfunction, Left / etiology*,  ultrasonography
Erratum In:
Rev Esp Cardiol. 2010 Sep;63(9):1110

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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