Document Detail


Effects of mitral valve surgery on myocardial energetics in patients with severe mitral regurgitation.
MedLine Citation:
PMID:  20194635     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hemodynamically significant mitral regurgitation (MR) may alter left ventricular (LV) myocardial energy requirements. The effects of MR and subsequent corrective mitral valve (MV) surgery on myocardial energetics are not well understood. A better understanding of myocardial energetics and the LV responses to changes in preload and afterload may assist with the understanding of mitral regurgitation and its effect on the LV. We sought to determine the effects of MV surgery on forward stroke work, myocardial oxidative metabolism, and myocardial efficiency. METHODS AND RESULTS: Prospectively enrolled patients with chronic, severe, nonischemic mitral regurgitation underwent echocardiography, radionuclide angiography, and C-11 acetate positron emission tomography to measure LV volumes, ejection fraction, and oxidative metabolism before and 1 year after MV surgery. Forward and total stroke work corrected for oxidative metabolism was used to estimate efficiency using the work metabolic index. Fourteen patients (age, 59+/- 8 years) with myxomatous MV were enrolled. One year after MV surgery, there was a reduction in LV end-diastolic and end-systolic volumes (231+/-86 to 131+/-21 mL; P<0.01 and 98+/-53 to 55+/-17 mL; P<0.01). Forward stroke volume increased (58.1+/-15.0 to 75.5+/-23 mL; P<0.01), LV ejection fraction was preserved without a significant change in oxidative metabolism. Forward work metabolic index improved (4.99+/-1.32 x 10(6) to 6.59+/-2.45 x 10(6) mm Hg x mL/m(2); P=0.02). This was not at the expense of total work metabolic index, which was preserved. CONCLUSIONS: MV surgery has a beneficial effect on forward stroke volume and forward work metabolic index without adverse effects on oxidative metabolism or total work metabolic index.
Authors:
Benjamin J W Chow; Joseph G Abunassar; Kathryn Ascah; Robert Dekemp; Jean Dasilva; Thierry Mesana; Rob S Beanlands; Terrence D Ruddy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-01
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-20     Completed Date:  2010-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  308-13     Citation Subset:  IM    
Affiliation:
University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y4W7, Canada. bchow@ottawaheart.ca
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MeSH Terms
Descriptor/Qualifier:
Echocardiography, Doppler / methods
Energy Metabolism
Female
Follow-Up Studies
Heart / radionuclide imaging
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / metabolism*,  surgery*
Myocardium / metabolism*
Oxidation-Reduction
Positron-Emission Tomography / methods
Prospective Studies
Severity of Illness Index
Stroke Volume

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


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