Preoperative transaortic forward flow: Prediction of surgical outcomes in patients with DCM and mitral regurgitation

Masanori Hirota, Minoru Yoshida, Joji Hoshino, Taichi Kondo, Tadashi Isomura

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background In patients with dilated cardiomyopathy and mitral regurgitation, preoperative prognostic factors are very important. Methods We hypothesized that preoperative transaortic forward flow might be related to postoperative survival, despite mitral regurgitant volume. We retrospectively evaluated surgical outcomes and echocardiographic parameters, including forward flow through the aortic valve. Results Seventy-nine patients (54 males, 25 females; mean age 59±12 years) with dilated cardiomyopathy and mitral regurgitation were divided into two groups according to postoperative outcome: 19 patients in group A suffered cardiac death, 60 in group B survived or died of another cause. In group A, death occurred after 227±116 days, group B patients survived (except one who died of infection) for 505±446 days; p<0.01. Preoperatively, there was no significant difference in ejection fraction, end-diastolic and end-systolic volume index, mitral regurgitant volume, effective regurgitant orifice area, or right ventricular systolic pressure. Preoperative transaortic forward flow was significantly lower in group A vs. group B (1.57±0.33 vs. 1.81±0.46Lm-2; p 0.04). In group B, transaortic forward flow was increased significantly before discharge (1.81±0.51 vs. 2.43±0.62Lm-2; p<0.01). Ejection fraction was significantly alleviated before discharge (28%±9% vs. 23%±8%; p<0.01) and recovered to the preoperative value without repeat dilation of the left ventricle in late follow-up. Conclusions Preoperative transaortic forward flow may be a predictor of survival in patients with dilated cardiomyopathy and mitral regurgitation, irrespective of mitral regurgitant volume.

Original languageEnglish
Pages (from-to)781-786
Number of pages6
JournalAsian Cardiovascular and Thoracic Annals
Volume23
Issue number7
DOIs
Publication statusPublished - Sep 13 2015
Externally publishedYes

Fingerprint

Mitral Valve Insufficiency
Dilated Cardiomyopathy
Survival
Ventricular Pressure
Aortic Valve
Heart Ventricles
Dilatation
Blood Pressure
Infection

Keywords

  • Cardiomyopathy
  • Dilated
  • Heart failure
  • Hemodynamics
  • Mitral valve insufficiency
  • Prognosis
  • Ventricular remodeling

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Preoperative transaortic forward flow : Prediction of surgical outcomes in patients with DCM and mitral regurgitation. / Hirota, Masanori; Yoshida, Minoru; Hoshino, Joji; Kondo, Taichi; Isomura, Tadashi.

In: Asian Cardiovascular and Thoracic Annals, Vol. 23, No. 7, 13.09.2015, p. 781-786.

Research output: Contribution to journalArticle

Hirota, Masanori ; Yoshida, Minoru ; Hoshino, Joji ; Kondo, Taichi ; Isomura, Tadashi. / Preoperative transaortic forward flow : Prediction of surgical outcomes in patients with DCM and mitral regurgitation. In: Asian Cardiovascular and Thoracic Annals. 2015 ; Vol. 23, No. 7. pp. 781-786.
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T2 - Prediction of surgical outcomes in patients with DCM and mitral regurgitation

AU - Hirota, Masanori

AU - Yoshida, Minoru

AU - Hoshino, Joji

AU - Kondo, Taichi

AU - Isomura, Tadashi

PY - 2015/9/13

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N2 - Background In patients with dilated cardiomyopathy and mitral regurgitation, preoperative prognostic factors are very important. Methods We hypothesized that preoperative transaortic forward flow might be related to postoperative survival, despite mitral regurgitant volume. We retrospectively evaluated surgical outcomes and echocardiographic parameters, including forward flow through the aortic valve. Results Seventy-nine patients (54 males, 25 females; mean age 59±12 years) with dilated cardiomyopathy and mitral regurgitation were divided into two groups according to postoperative outcome: 19 patients in group A suffered cardiac death, 60 in group B survived or died of another cause. In group A, death occurred after 227±116 days, group B patients survived (except one who died of infection) for 505±446 days; p<0.01. Preoperatively, there was no significant difference in ejection fraction, end-diastolic and end-systolic volume index, mitral regurgitant volume, effective regurgitant orifice area, or right ventricular systolic pressure. Preoperative transaortic forward flow was significantly lower in group A vs. group B (1.57±0.33 vs. 1.81±0.46Lm-2; p 0.04). In group B, transaortic forward flow was increased significantly before discharge (1.81±0.51 vs. 2.43±0.62Lm-2; p<0.01). Ejection fraction was significantly alleviated before discharge (28%±9% vs. 23%±8%; p<0.01) and recovered to the preoperative value without repeat dilation of the left ventricle in late follow-up. Conclusions Preoperative transaortic forward flow may be a predictor of survival in patients with dilated cardiomyopathy and mitral regurgitation, irrespective of mitral regurgitant volume.

AB - Background In patients with dilated cardiomyopathy and mitral regurgitation, preoperative prognostic factors are very important. Methods We hypothesized that preoperative transaortic forward flow might be related to postoperative survival, despite mitral regurgitant volume. We retrospectively evaluated surgical outcomes and echocardiographic parameters, including forward flow through the aortic valve. Results Seventy-nine patients (54 males, 25 females; mean age 59±12 years) with dilated cardiomyopathy and mitral regurgitation were divided into two groups according to postoperative outcome: 19 patients in group A suffered cardiac death, 60 in group B survived or died of another cause. In group A, death occurred after 227±116 days, group B patients survived (except one who died of infection) for 505±446 days; p<0.01. Preoperatively, there was no significant difference in ejection fraction, end-diastolic and end-systolic volume index, mitral regurgitant volume, effective regurgitant orifice area, or right ventricular systolic pressure. Preoperative transaortic forward flow was significantly lower in group A vs. group B (1.57±0.33 vs. 1.81±0.46Lm-2; p 0.04). In group B, transaortic forward flow was increased significantly before discharge (1.81±0.51 vs. 2.43±0.62Lm-2; p<0.01). Ejection fraction was significantly alleviated before discharge (28%±9% vs. 23%±8%; p<0.01) and recovered to the preoperative value without repeat dilation of the left ventricle in late follow-up. Conclusions Preoperative transaortic forward flow may be a predictor of survival in patients with dilated cardiomyopathy and mitral regurgitation, irrespective of mitral regurgitant volume.

KW - Cardiomyopathy

KW - Dilated

KW - Heart failure

KW - Hemodynamics

KW - Mitral valve insufficiency

KW - Prognosis

KW - Ventricular remodeling

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