Document Detail


Echocardiography predictors and prognostic value of pulmonary artery systolic pressure in chronic organic mitral regurgitation.
MedLine Citation:
PMID:  20659951     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the predictors of pulmonary artery systolic pressure (PASP) in organic mitral regurgitation (MR) and its prognostic value after surgery. DESIGN: Prospective observational study, conducted from 1998 to 2006. SETTING: Echocardiography and cardiac surgery departments, University Hospital. PATIENTS: Echocardiography was carried out in 256 patients (63+/-12 years, 170 male) with organic MR (degenerative aetiology: 91%) referred for surgery. MAIN OUTCOME MEASURES: Echocardiography predictors of PASP. Postoperative end points were overall mortality and cardiovascular mortality. RESULTS: Baseline PASP was 45+/-14 mmHg, ranging from 25 to 105 mmHg. PASP was > or = 50 mmHg in 82 patients (32%). Left atrial volume (p=0.003), mitral deceleration time (p<0.0001) and mitral medial E/E' (p<0.0001) were independent predictors of PASP, whereas left ventricular size and systolic function were not predictors. Mitral valve repair was performed in 194 patients (76%) and mitral valve replacement in 62 (24%). In a Cox model mitral valve repair (HR=0.41 (95% CI 0.20 to 0.85), p=0.016) and PASP (HR=1.43 (95% CI 1.09 to 1.88) per 10 mmHg increment, p=0.011) were independent predictors of overall mortality, even after adjustment for known predictors. PASP (HR=1.49 (95% CI 1.03 to 2.16) per 10 mmHg increment, p=0.033) was also an independent predictor of cardiac mortality. Eight-year survival after surgery was 58.6% and 86.6% in patients with baseline PASP > or = 50 mmHg or <50 mmHg, respectively (p<0.0001). CONCLUSIONS: In organic MR, mitral deceleration time, mitral E/E' and left atrial volume correlate with PASP. Pulmonary artery systolic pressure > or = 50 mmHg is an independent predictor of overall and cardiovascular mortality after surgery in organic MR.
Authors:
Thierry Le Tourneau; Marjorie Richardson; Francis Juthier; Thomas Modine; Georges Fayad; Anne-Sophie Polge; Pierre-Vladimir Ennezat; Christophe Bauters; André Vincentelli; Ghislaine Deklunder
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1311-7     Citation Subset:  AIM; IM    
Affiliation:
Inserm, UMR 915, Institut du Thorax, Nantes, France. thletourneau@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / physiology
Chronic Disease
Echocardiography, Doppler / methods
Epidemiologic Methods
Female
Heart Valve Prosthesis Implantation
Hemodynamics / physiology
Humans
Male
Middle Aged
Mitral Valve Insufficiency / physiopathology*,  surgery,  ultrasonography
Prognosis
Pulmonary Artery / physiopathology*,  ultrasonography
Treatment Outcome

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


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