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Tissue Doppler Imaging Predicts Left Ventricular Reverse Remodeling After Surgery for Mitral Regurgitation.
MedLine Citation:
PMID:  24021767     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Tissue Doppler imaging of systolic mitral annular velocity (Sm) has been shown to be able to detect early left ventricular (LV) dysfunction in the presence of chronic severe mitral regurgitation with normal left ventricular ejection fraction. We investigated the association of preoperative Sm with LV reverse remodeling after mitral valve surgery.
METHODS: Patients with chronic severe organic mitral regurgitation exhibiting LV ejection fraction greater than 60% were enrolled. The LV reverse remodeling was defined as changes of LV mass index of 20% or greater postoperatively. The primary endpoints were to compare the changes of LV mass index in relation to the tertile distribution of the Sm and evaluate predictive value of the Sm for LV reverse remodeling.
RESULTS: In all, 169 patients were analyzed. The changes of LV mass index in the first tertile was 25% (11% to 37) compared with 34% (19% to 43%) in the second tertile and 34% (26% to 47%) in the third tertile (p = 0.003). On multivariate analysis, Sm was the only independent predictor of LV reverse remodeling (odds ratio 1.77, 95% confidence interval: 1.30 to 2.40, p < 0.001). The optimal cutoff value measured by receiver-operating characteristic curve analysis was 7 cm/s of Sm (area under the curve 0.721, 95% confidence interval: 0.64 to 0.80, p < 0.001).
CONCLUSIONS: In patients with severe mitral regurgitation exhibiting LV ejection fraction greater than 60%, surgery may be considered before the Sm is decreased below 7 cm/s to achieve favorable LV reverse remodeling.
Authors:
Young Song; Sak Lee; Young-Lan Kwak; Chi-Young Shim; Byung-Chul Chang; Jae-Kwang Shim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-7
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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