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 language | English |
|---|---|
| Pages (from-to) | 781-786 |
| Number of pages | 6 |
| Journal | Asian Cardiovascular and Thoracic Annals |
| Volume | 23 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Sep 13 2015 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Preoperative transaortic forward flow
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
Y1 - 2015/9/13
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
UR - http://www.scopus.com/inward/record.url?scp=84939155662&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939155662&partnerID=8YFLogxK
U2 - 10.1177/0218492315583764
DO - 10.1177/0218492315583764
M3 - Article
C2 - 26084956
AN - SCOPUS:84939155662
VL - 23
SP - 781
EP - 786
JO - Asian Cardiovascular and Thoracic Annals
JF - Asian Cardiovascular and Thoracic Annals
SN - 0218-4923
IS - 7
ER -