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Prediction of left ventricular ejection fraction 6 months after surgical correction of organic mitral regurgitation: the value of exercise echocardiography and deformation imaging.
MedLine Citation:
PMID:  22504944     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: Left ventricular (LV) end-systolic diameter and LV ejection fraction (LVEF) are correlated with postoperative LVEF and prognosis in patients with organic mitral regurgitation (MR). However, in some patients, the LVEF does not return to normal 6 months postoperatively, despite normal preoperative diameters. Thus, our study aimed to evaluate whether preoperative LV strain values assessed by echocardiography at rest and during exercise were predictors of postoperative LVEF at 6-month follow-up in patients undergoing surgery for severe organic MR. METHODS AND RESULTS: In total, 88 patients with severe organic MR (mean age 62.6 ± 1.4 years) were prospectively recruited. All patients underwent an echocardiogram at rest and submaximal exercise (110 ± 10 bpm) prior to surgery and then at rest 6 months after surgery. Exclusion criteria were significant coronary artery disease, other organic valvular diseases, uncontrolled arrhythmia, and haemodynamic instability. Among the 88 patients, 77 had complete data sets with rest and exercise echocardiograms and underwent isolated mitral valve surgery (repaired, n= 72). Global longitudinal strain (GLS) at rest (R= -0.42, P= 0.011) and during exercise (R= -0.36, P= 0.034) correlated with postoperative LVEF. When normalized for LV end-systolic diameter, GLS during exercise was more closely correlated with postoperative LVEF and was its best predictor based on a multivariate linear regression model. At a cut-off of -5.7%/cm, sensitivity was 0.83, specificity 0.70, negative predictive value 0.64, and positive predictive value 0.86 for predicting a 6-month postoperative LVEF of <50%. CONCLUSION: In patients undergoing surgery for severe organic MR, GLS normalized for LV end-systolic diameter at submaximal exercise may be used as a predictor of postoperative LVEF.
Authors:
Erwan Donal; Sophie Mascle; Anne Brunet; Christophe Thebault; Herve Corbineau; Marcel Laurent; Alain Leguerrier; Philippe Mabo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-14
Journal Detail:
Title:  European heart journal cardiovascular Imaging     Volume:  -     ISSN:  2047-2412     ISO Abbreviation:  Eur Heart J Cardiovasc Imaging     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101573788     Medline TA:  Eur Heart J Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, CIT-IC 804, INSERM U1099 LTSI, Hospital Pontchaillou-University Medical Center, Rue Henri-Le-Guillou, Rennes 35033, France.
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