TITLE

Echocardiography predictors and prognostic value of pulmonary artery systolic pressure in chronic organic mitral regurgitation

AUTHOR(S)
Le Tourneau, Thierry; Richardson, Marjorie; Juthier, Francis; Modine, Thomas; Fayad, Georges; Polge, Anne-Sophie; Ennezat, Pierre-Vladimir; Bauters, Christophe; Vincentelli, Andr�; Deklunder, Ghislaine
PUB. DATE
August 2010
SOURCE
Heart;Aug2010, Vol. 96 Issue 16, p10
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective To evaluate the predictors of pulmonary artery systolic pressure (PASP) in organic mitral regurgitation (MR) and its prognostic value after surgery. Design Prospective observational study, conducted from 1998 to 2006. Setting Echocardiography and cardiac surgery departments, University Hospital. Patients Echocardiography was carried out in 256 patients (63�12 years, 170 male) with organic MR (degenerative aetiology: 91%) referred for surgery. Main outcome measures Echocardiography predictors of PASP. Postoperative end points were overall mortality and cardiovascular mortality. Results Baseline PASP was 45�14 mmHg, ranging from 25 to 105 mmHg. PASP was =50 mmHg in 82 patients (32%). Left atrial volume (p=0.003), mitral deceleration time (p<0.0001) and mitral medial E/E' (p<0.0001) were independent predictors of PASP, whereas left ventricular size and systolic function were not predictors. Mitral valve repair was performed in 194 patients (76%) and mitral valve replacement in 62 (24%). In a Cox model mitral valve repair (HR=0.41 (95% CI 0.20 to 0.85), p=0.016) and PASP (HR=1.43 (95% CI 1.09 to 1.88) per 10 mmHg increment, p=0.011) were independent predictors of overall mortality, even after adjustment for known predictors. PASP (HR=1.49 (95% CI 1.03 to 2.16) per 10 mmHg increment, p=0.033) was also an independent predictor of cardiac mortality. Eight-year survival after surgery was 58.6% and 86.6% in patients with baseline PASP =50 mmHg or <50 mmHg, respectively (p<0.0001). Conclusions In organic MR, mitral deceleration time, mitral E/E' and left atrial volume correlate with PASP. Pulmonary artery systolic pressure =50 mmHg is an independent predictor of overall and cardiovascular mortality after surgery in organic MR.
ACCESSION #
55115932

Tags: PULMONARY artery;  HEART -- Contraction;  MITRAL valve insufficiency;  PROGNOSIS;  SURGERY

 

Related Articles

  • Republished review: Mitral regurgitation in patients with aortic stenosis undergoing valve replacement. P Unger // Postgraduate Medical Journal;Feb2011, Vol. 87 Issue 1024, p150 

    Mitral regurgitation is a frequent finding in patients with aortic stenosis scheduled for aortic valve replacement. Detection of mitral regurgitation in such patients has important implications, as it can independently affect functional status and prognosis. When mitral regurgitation is moderate...

  • 1060 Factors associated with pulmonary artery pressure rise in mitral regurgitation related to valve prolapse. LeTourneau, T.; Polge, A.S.; Vanesson, C.; Pouwels, S.; Darchies, J.; Yameogo, A.; Bauters, C.; Deklunder, G. // European Journal of Echocardiography;Dec2006 Supplement 1, Vol. 7, pS179 

    An abstract of the article "Factors associated with pulmonary artery pressure rise in mitral regurgitation related to valve prolapse," by T. Le Tourneau and colleagues is presented.

  • Non-rheumatic mitral regurgitation.  // British Medical Journal (Clinical Research Edition);6/27/1981, Vol. 282 Issue 6282, p2076 

    Evaluates the non-rheumatic mitral regurgitation in Great Britain. Cause of isolated mitral regurgitation; Recommendations on the treatment of acute mitral regurgitation; Factors influencing the surgery of patients with mitral regurgitation.

  • Anomalous origin of the left coronary artery from the pulmonary artery: late results with special attention to the mitral valve. Ben Ali, Walid; Metton, Olivier; Roubertie, François; Pouard, Philippe; Sidi, Daniel; Raisky, Olivier; Vouhé, Pascal R. // European Journal of Cardio-Thoracic Surgery;Aug2009, Vol. 36 Issue 2, p244 

    Abstract: Objective: Evaluate the late results of a uniform approach to the surgical management of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Methods: Between 1986 and 2007, 62 children with ALCAPA underwent surgery. The median age at operation...

  • A systematic review on the safety and efficacy of percutaneous edge-to-edge mitral valve repair with the MitraClip system for high surgical risk candidates. Munkholm-Larsen, Stine; Benjamin Wan; Tian, David H.; Kearney, Katherine; Rahnavardi, Mohammad; Dixen, Ulrik; Køber, Lars; Alfieri, Ottavio; Yan, Tristan D. // Heart;Mar2014, Vol. 100 Issue 6, p473 

    Background: MitraClip implantation has emerged as a viable option in high surgical risk patients with severe mitral regurgitation (MR). We performed the present systematic review to assess the safety and efficacy of the MitraClip system for high surgical risk candidates with severe organic...

  • Mitral regurgitation in patients with aortic stenosis undergoing valve replacement. Unger, P.; Dedobbeleer, C.; Van Camp, G.; Plein, D.; Cosyns, B.; Lancellotti, P. // Heart;Jan2010, Vol. 96 Issue 1, p9 

    Mitral regurgitation is a frequent finding in patients with aortic stenosis scheduled for aortic valve replacement. Detection of mitral regurgitation in such patients has important implications, as it can independently affect functional status and prognosis. When mitral regurgitation is moderate...

  • Clinical and functional characterisation of rheumatic mitral regurgitation in children and adolescents including the brain natriuretic peptide. Ribeiro, Maria C. V.; Filho, Brivaldo Markman; Santos, Cleusa C. L.; Mello, Cristina P. Q. // Cardiology in the Young;Feb2010, Vol. 20 Issue 1, p66 

    Rheumatic fever is a public health problem of universal distribution, predominantly affecting individuals in developing countries. In individuals less than 20 years of age, pure mitral regurgitation is the most commonly found condition in chronic rheumatic valve disease. In the present study,...

  • EVEREST II: Safety, efficacy remain stable at 2-year mark.  // Cardiology Today;May2011, Vol. 14 Issue 5, p11 

    This article discusses the results of the EVEREST II trial which examined the efficacy of percutaneous repair with MitraClip in patients with mitral regurgitation.

  • Clinical trial experience with the MitraClip catheter based mitral valve repair system. Maisano, Francesco; Godino, Cosmo; Giacomini, Andrea; Denti, Paolo; Arendar, Iryna; Buzzatti, Nicola; Canna, Giovanni; Alfieri, Ottavio; Colombo, Antonio // International Journal of Cardiovascular Imaging;Dec2011, Vol. 27 Issue 8, p1155 

    Severe mitral regurgitation (MR) confers a poor prognosis, in particular for patients with heart failure. Based on the results of the Euro Heart Survey, a large proportion of patients with mitral regurgitation is not referred to surgery and many other patients are rejected for cardiac surgery...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics