Document Detail


Mitral valve repair for dilated cardiomyopathy: predictive role of right ventricular dysfunction.
MedLine Citation:
PMID:  17890302     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To evaluate the impact of right ventricular (RV) dysfunction on early and mid-term outcome of patients with ischaemic or dilated cardiomyopathy (DCM) undergoing mitral valve annuloplasty. METHODS AND RESULTS: From January 1997 to December 2005, 111 patients with DCM (89 ischaemic, 22 non-ischaemic) were enrolled in this retrospective study. Mean age was 67 +/- 10 years. Average pre-operative NYHA class was 3.0 +/- 0.6. Tricuspid annular plane systolic excursion (TAPSE), tricuspid annular pleak systolic velocity (TAPSV), and RV fractional area change were considered as an index of RV function. A strong relationship between TAPSE and TAPSV were found (r = 0.76). Thirty-day mortality was 10.8%. Five-year survival and possibility to be alive in NYHA classes I-II were 66.5 +/- 5.0 and 59.5 +/- 5.0%. TAPSE, TAPSV, and MV coaptation depth (MVCD) were found to be risk factors for worse early and mid-term outcome; functional class impaired mid-term outcome. ROC analysis identified TAPSE < or = 12 mm, TAPSV < or = 10 cm/s, and MVCD>10 mm as predictive cut-offs. CONCLUSION: Pre-operative assessment of some echocardiographic parameters (TAPSE, TAPSV) is very easy, low cost, and provides accurate information on RV function. A good pre-operative clinical compensation has to be necessarily reached before the operation. MVCD should be evaluated to decide surgical strategy (repair or replace).
Authors:
Michele Di Mauro; Antonio Maria Calafiore; Maria Penco; Silvio Romano; Gabriele Di Giammarco; Sabina Gallina
Publication Detail:
Type:  Journal Article     Date:  2007-09-21
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-22     Completed Date:  2008-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2510-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, San Camillo Hospital, via Forlanini 50, University G D'Annunzio, 66100 Chieti, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathy, Dilated / complications,  surgery*
Disease-Free Survival
Echocardiography / methods
Female
Humans
Italy
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / etiology,  surgery*,  ultrasonography
Predictive Value of Tests
ROC Curve
Retrospective Studies
Ventricular Dysfunction, Right / etiology,  surgery*,  ultrasonography

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


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