The prognostic value of changes in pulmonary vein flow patterns after surgical repair for primary mitral regurgitation.

Autor: Yedidya I; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands; Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva 49100, Israel; Affiliated with the Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. Electronic address: I.Yedidya@lumc.nl., Stassen J; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands; Department of Cardiology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium., Butcher S; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands; Department of Cardiology, Royal Perth Hospital, Victoria Square, Perth, WA 6000, Australia., van Wijngaarden AL; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands., Wu Y; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands., van der Bijl P; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands., Marsan NA; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands., Delgado V; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands., Bax J; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands; Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2024 Nov 01; Vol. 414, pp. 132414. Date of Electronic Publication: 2024 Aug 03.
DOI: 10.1016/j.ijcard.2024.132414
Abstrakt: Background: The pulmonary vein (PV) flow pattern is influenced by the presence of mitral regurgitation (MR). After a successful reduction in MR severity, the pattern is expected to be changed. We aimed to evaluate the prognostic value of a change in the PV flow pattern in patients with primary MR undergoing mitral valve repair (MVR).
Methods: The PV flow pattern was assessed with transthoracic echocardiography in 216 patients (age 65 [IQR 56-72] years, 70% male) with primary MR before and after surgical MVR. The population was divided according to a change in the PV flow pattern following MVR into 'improvers' and 'non-improvers'.
Results: Non-improvers (15%) had a higher prevalence of paroxysmal AF at baseline (46% vs. 22%, p = 0.004), left ventricular dysfunction (LVEF ≤60%) (39% vs. 21%, p = 0.020), and had lower systolic pulmonary artery pressure (28[IQR 25-38] vs. 35[IQR 26-48] mmHg, p = 0.018) compared to improvers (85%). After a median follow-up of 83[IQR 43-140] months, 26(12%) patients died. Non-improvers had higher mortality rates than improvers (p = 0.009). On multivariable Cox regression analysis, a lack of improvement in the PV flow pattern remained independently associated with all-cause mortality (HR 2.322, 95% CI 1.140 to 4.729, P = 0.020).
Conclusion: A lack of improvement in the PV flow pattern is independently associated with worse long-term survival in patients with primary MR undergoing MVR.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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