significant reduction in left atrial (LA) (p=0.001) and LV enddiastolic M-mode dimensions (p=0.001) and volumes (p=0.006), with no change in LV end-systolic volumes, yielding a significant reduction in LV functional measures (fractional shortening (34.5 vs 31.5%, p=0.006), fourchamber ejection fraction (62.6 vs 51.7%, p=0.002) and LV longitudinal strain (-24.3 vs-18.2%, p,0.001). Compared to controls, LA and LV dimensions remained increased with a reduction in all functional parameters after repair. There was a moderate negative correlation between preoperative enddiastolic volumes and postoperative longitudinal strain (r 2 =0.35). Discussion: Persistent LV and LA remodelling with decreased LV function is observed after repair of RHD-MR. While these results reflect changes to volume loading, the unmasking of decreased LV function and persistent remodelling; and linear relation to preoperative LV size, may suggest that early intervention to alleviate MR could benefit selected patients and warrants further study.
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