Left ventricular remodeling following ischemic mitral valve repair: predictive factors

Scand Cardiovasc J. 2009 Feb;43(1):57-62. doi: 10.1080/14017430802478280.

Abstract

Objectives: Annuloplasty is the most common surgical procedure for ischemic mitral regurgitation (MR) that improves symptoms but is also subjected to high incidence of recurrent MR. One of the reasons of recurrent MR could be further left ventricular (LV) remodeling.

Design: The study population consisted of 195 patients with ischemic MR. Mitral valve repair and bypass surgery was performed between 2000 and 2006.

Results: LV end diastolic diameter (LVEDD) increased in 30.3% of patients in one year following mitral repair. Multivariate ANOVA analysis revealed that if LVEDD index (LVEDDi) before surgery is less than 25 mm/m(2), the probability for LVEDDi to diminish or to stay at the same range is 84.6% higher, than in the case of preoperative LVEDDi >or=25 mm/m(2) and other predictive variables.

Conclusions: Predictive factors for further LV remodeling after ischemic mitral repair 1 year after surgery are preoperative LVEDDi, preoperative LV end systolic diameter index, tricuspid regurgitation grade before surgery, and early postoperative MR grade.

MeSH terms

  • Aged
  • Cardiac Surgical Procedures*
  • Female
  • Heart Ventricles / pathology
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / etiology
  • Mitral Valve Insufficiency / pathology
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Myocardial Ischemia / complications*
  • Myocardial Ischemia / pathology
  • Myocardial Ischemia / physiopathology
  • Myocardial Ischemia / surgery
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tricuspid Valve Insufficiency / complications
  • Ventricular Function, Left*
  • Ventricular Remodeling*