Document Detail


Left atrial remodelling early after mitral valve repair for degenerative mitral regurgitation.
MedLine Citation:
PMID:  17690156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Left atrial (LA) size is an important predictor of outcome after mitral valve replacement in patients with symptomatic chronic mitral regurgitation (MR). Data on LA remodelling after mitral valve repair (MVr) for chronic non-ischaemic MR are scarce. The aim of this study was to assess changes in LA size early after MVr for chronic severe degenerative MR and to identify clinical and echocardiographic correlates of those changes. METHODS: The study analysed 225 consecutive patients who underwent MVr and were echocardiographically evaluated in our hospital within 1 month before and 1-6 months after surgery. Patients with MR aetiology other than degenerative, associated aortic valve replacement, or congenital heart disease were excluded. The remaining 79 patients (aged 60 (SD 12) years, 55 men) with isolated chronic severe degenerative MR formed the study group. LA reverse remodelling was defined as a decrease in LA volume index (LAVi) > or = 15%. RESULTS: LA dimensions significantly decreased after MVr (p<0.001). Mean LAVi reduction was 29% (SD 18%). LA reverse remodelling was observed in 63 patients (80%). Correlates of LAVi reduction were preoperative LAVi (p = 0.008), systolic and diastolic blood pressure (p = 0.032, p = 0.009), postoperative transmitral mean pressure gradient (p = 0.001) and residual MR (p = 0.043). LAVi reduction was lower in patients > 45 years (p = 0.008) and in hypertensive patients (p = 0.031). CONCLUSION: LA reverse remodelling is common early after MVr for chronic severe degenerative MR. Preoperative LAVi, blood pressure, postoperative transmitral mean pressure gradient, residual MR and age > 45 are related to LAVi reduction. The prognostic value of LA reduction in this setting needs further study.
Authors:
F Antonini-Canterin; C C Beladan; B A Popescu; C Ginghina; A C Popescu; R Piazza; E Leiballi; B Zingone; G L Nicolosi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-09
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  94     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-15     Completed Date:  2008-06-11     Revised Date:  2008-10-24    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  759-64     Citation Subset:  AIM; IM    
Affiliation:
Cardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Via Montereale, 24, 33170 Pordenone, Italy. cardiologia@aopn.fvg.it
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Echocardiography, Doppler / methods
Female
Humans
Male
Middle Aged
Mitral Valve / surgery*,  ultrasonography
Mitral Valve Insufficiency / physiopathology,  surgery*,  ultrasonography
Reoperation
Treatment Outcome
Ventricular Outflow Obstruction / physiopathology,  surgery*,  ultrasonography
Ventricular Remodeling / physiology*
Comments/Corrections
Erratum In:
Heart. 2008 Jul;94(7):935

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


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