Relationship between myocardial energy expenditure and postoperative ejection fraction in patients with severe mitral regurgitation
| Autor: | Anil Sahin, Alev Kilicgedik, Ahmet Güner, Ismail Gurbak, Oya Atamaner, Mehmet Ali Astarcıoğlu, Gamze Babur Guler, Hicaz Zencirkiran Agus, Ahmet Yasar Cizgici |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system medicine.drug_class medicine.medical_treatment 030204 cardiovascular system & hematology Effective Regurgitant Orifice Area myocardial energy expenditure Ventricular Dysfunction Left 03 medical and health sciences Basal (phylogenetics) 0302 clinical medicine Statistical significance Internal medicine end-systolic stress medicine Natriuretic peptide Humans Heart Atria Postoperative Period Prospective Studies 030212 general & internal medicine Prospective cohort study ejection fraction Original Investigation Aged Mitral regurgitation Mitral valve repair Ejection fraction business.industry Mitral Valve Insufficiency Stroke Volume Middle Aged lcsh:RC666-701 Cardiology Female mitral regurgitation Energy Metabolism Cardiology and Cardiovascular Medicine business mitral valve surgery |
| Zdroj: | Anatolian Journal of Cardiology, Vol 24, Iss 4, Pp 254-259 (2020) Anatolian Journal of Cardiology |
| ISSN: | 2149-2263 |
| Popis: | Objective This prospective study aimed to investigate the myocardial energy metabolism in severe mitral regurgitation (MR) and explore its effect on postoperative differentiation of ejection fraction (EF). Methods A total of 85 patients with severe MR were prospectively enrolled from October 2018 to June 2019. During the study period, a total of 50 patients underwent mitral valve surgery and 49 patients were finally enrolled due to 1 missing data. Left ventricular function, circumferential end-systolic stress (cESS), and myocardial energy expenditure (MEE) were measured by transthoracic echocardiography preoperatively and 3 months after surgery. Patients were divided into 2 groups according to absolute difference of postoperative differentiation of EF. Results Nine patients underwent mitral valve repair and 40 underwent prosthetic valve replacement. Patients with reduced EF had higher MEE demonstrated with cESS and MEE. Negative correlation between preoperative EF and N-terminal pro-brain natriuretic peptide (NT-proBNP), cESS, MEEs, and MEEm and positive correlation between preoperative EF and effective regurgitant orifice area were found. Complications occurred in 12 patients during hospitalization. Basal NT-proBNP, left atrium (LA), and cESS were significantly higher in postoperatively decreased EF group. Taking into consideration the covariates of multiple logistic regression analysis, LA and cESS were found to be independent predictors of EF reduction postoperatively. Conclusion Higher LA and cESS are independent predictors of postoperative EF reduction. Preoperative high end-systolic stress could predict postoperative EF reduction and hence could be helpful for determining the timing of mitral valve surgery. Although MEE was higher in postoperatively decreased EF group, it did not reach statistical significance. |
| Databáze: | OpenAIRE |
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