Preoperative left ventricular ejection fraction and left atrium reverse remodeling after mitral regurgitation surgery

Preoperative left ventricular ejection fraction and left atrium reverse remodeling after mitral regurgitation surgery

Author Machado, Lucia R. Google Scholar
Meneghelo, Zilda M. Google Scholar
Le Bihan, David C. S. Google Scholar
Barretto, Rodrigo B. M. Google Scholar
Carvalho, Antonio C. Autor UNIFESP Google Scholar
Moises, Valdir A. Autor UNIFESP Google Scholar
Institution Inst Dante Pazzanese Cardiol
Universidade Federal de São Paulo (UNIFESP)
Disciplina Cardiol
Abstract Background: Left atrium enlargement has been associated with cardiac events in patients with mitral regurgitation (MR). Left atrium reverse remodeling (LARR) occur after surgical correction of MR, but the preoperative predictors of this phenomenon are not well known. It is therefore important to identify preoperative predictors for postoperative LARR.Methods: We enrolled 62 patients with chronic severe MR (prolapse or flail leaflet) who underwent successful mitral valve surgery (repair or replacement); all with pre-and postoperative echocardiography. LARR was defined as a reduction in left atrium volume index (LAVI) of >= 25%. Stepwise multiple regression analysis was used to identify independent predictors of LARR.Results: LARR occurred in 46 patients (74.2%), with the mean LAVI decreasing from 85.5 mL/m(2) to 49.7 mL/m(2) (p <0.001). These patients had a smaller preoperative left ventricular systolic volume (p =0.022) and a higher left ventricular ejection fraction (LVEF) (p =0.034). LVEF was identified as the only preoperative variable significantly associated with LARR (odds ratio, 1.086; 95% confidence interval, 1.002-1.178). A LVEF cutoff value of 63.5% identified patients with LARR of >= 25% with a sensitivity of 71.7% and a specificity of 56.3%.Conclusions: LARR occurs frequently after mitral valve surgery and is associated with preoperative LVEF higher than 63.5%.
Keywords Mitral valve insufficiency
Mitral valve surgery
Left atrial remodeling
Left atrial volume
Language English
Date 2014-11-06
Published in Cardiovascular Ultrasound. London: Biomed Central Ltd, v. 12, 5 p., 2014.
ISSN 1476-7120 (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent 5
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000345939900001

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