Recovery of left ventricular function after surgery for aortic and mitral regurgitation with heart failure.

Autor:	Lai WT; Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hsinchu Hospital, Hsinchu, Taiwan.; Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan., Chen IC; Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan., Hsiung MC; Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan., Lin TC; Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan.; Institute of Emergency and Critical Care Medicine, National Yang Ming University, Taipei, Taiwan., Huang KC; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan., Chang CY; Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan., Wei J; Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Cardiovascular risk and prevention [Int J Cardiol Cardiovasc Risk Prev] 2024 Sep 02; Vol. 23, pp. 200329. Date of Electronic Publication: 2024 Sep 02 (Print Publication: 2024).
DOI:	10.1016/j.ijcrp.2024.200329
Abstrakt:	Background: Severe aortic regurgitation (AR) and mitral regurgitation (MR) can lead to left ventricular (LV) systolic dysfunction; however, there are limited data about recovery of LV after surgery for AR or MR. Little is known to guide the management of combined AR and MR (mixed valvular heart disease [VHD]). This study is sought to investigate the predictors of postoperative LV function recovery in left-sided regurgitant VHD with reduced left ventricular ejection fraction (LVEF), especially for mixed VHD. Methods: From 2010 to 2020, 2053 adult patients underwent aortic or mitral valve surgery at our center. The patients with valvular stenosis, infective endocarditis, concomitant revascularization, and preoperative LVEF ≥40 % were excluded. A total of 127 patients were included in this study: 22 patients with predominant AR (AR group), 64 with predominant MR (MR group), and 41 with combined AR and MR (AMR group). Results: The mean preoperative LVEF was 32.4 %, 30.7 %, and 30.2 % (p = 0.44) in the AR, MR, and AMR groups, respectively. The AR group was more likely to have postoperative LVEF recovery. The cut-point of left ventricular end-systolic diameter (LVESD) for better recovery was 49 mm for the MR group and 58 mm for the AMR group. Conclusion: LV dysfunction due to combined AR and MR has similar remodeling reserve as AR, and better recoverability than MR. Thus, double-valve surgery is recommended before the LVESD is > 58 mm. Competing Interests: All authors stated that there is no conflict of interest. (© 2024 The Authors. Published by Elsevier B.V.)
Databáze:	MEDLINE
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