| Functional and prognostic implications of left ventricular contractile reserve in patients with asymptomatic severe mitral regurgitation. | |
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MedLine Citation:
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PMID: 16230438 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate contractile reserve (CR) determined by exercise echocardiography in predicting clinical outcome and left ventricular (LV) function in asymptomatic severe mitral regurgitation (MR). DESIGN: Cohort study. SETTING: Regional cardiac centre. PATIENTS AND OUTCOME MEASURES: LV volumes and ejection fraction (EF) were measured at rest and after stress in 71 patients with isolated MR. During follow up (mean (SD) 3 (1) years), EF and functional capacity were serially assessed and cardiac events (cardiac death, heart failure, and new atrial fibrillation) were documented. RESULTS: CR was present in 45 patients (CR+) and absent in 26 patients (CR-). Age, resting LV dimensions, EF, and MR severity were similar in both groups. Mitral surgery was performed in 19 of 45 (42%) CR+ patients and 22 of 26 (85%) CR- patients. In patients undergoing surgery, CR was an independent predictor of follow up EF (p = 0.006) and postoperative LV dysfunction (EF < 50%) persisted in five patients, all in the CR- group. Event-free survival was lower in surgically treated patients without CR (p = 0.03). In medically treated patients, follow up EF was preserved in those with intact CR but progressively deteriorated in patients without CR, in whom functional capacity also deteriorated. CONCLUSIONS: Evaluation of CR by exercise echocardiography may be useful for risk stratification and may help to optimise the timing of surgery in asymptomatic severe MR. |
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Authors:
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R Lee; B Haluska; D Y Leung; C Case; J Mundy; T H Marwick |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 91 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-10-18 Completed Date: 2005-12-15 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 1407-12 Citation Subset: AIM; IM |
Affiliation:
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University of Queensland, Brisbane, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Chronic Disease Cohort Studies Echocardiography / methods Echocardiography, Stress / methods Epidemiologic Methods Female Humans Male Middle Aged Mitral Valve Insufficiency / physiopathology*, surgery Postoperative Period Prognosis Stroke Volume / physiology Ventricular Dysfunction, Left / physiopathology* |
| Comments/Corrections | |
Comment In:
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Heart. 2005 Nov;91(11):1383-4
[PMID:
16230432
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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