Left Ventricular Remodeling Shortly after Open Mitral Valve Replacement for Rheumatic Mitral Stenosis

Ferreira, Maria Aparecida Santana; Cunha, Claúdio Ribeiro da; Oliveira, Gabrielle Santos; Otto, Maria Estefânia Bosco; Atik, Fernando Antibas

doi:10.21470/1678-9741-2020-0641

Cited by 2 publications

(2 citation statements)

References 21 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, a positive correlation was found between MVA and impaired longitudinal strain rates. 24 , 25 Nevertheless, there is limited research on predictors of adverse left ventricular remodeling after surgery for rheumatic valvular disease.Active monitoring based on echocardiography screening is a routine test method for early efficacy. 26 LVGLS can reflect the contraction of myocardial fibers under the intima and effectively reflect the abnormal contraction movement of myocardial function.…”

Section: Discussionmentioning

confidence: 99%

Speckle-Tracking Echocardiography Predicts Adverse Left Ventricular Remodeling After Valve Replacement in Rheumatic Mitral Stenosis

Zhang,

Cai

et al. 2023

TCRM

View full text Add to dashboard Cite

Background Rheumatic mitral stenosis(RMS) may leads to left ventricular remodeling (LVR), which can persist even after valve surgery. Identifying markers for early structure and function in patients with rheumatic heart disease who are at risk for adverse LVR after surgery can help determine the optimal timing of intervention. This study aimed to investigate whether preoperative parameters of global left ventricular long-axis strain (LVGLS) and mechanical discretization (MD) could predict postoperative adverse LVR. Methods A total of 109 adult patients with RMS and 50 healthy controls were enrolled in this study. Baseline clinical features, conventional echocardiography results, LVGLS, and MD were compared between the two groups. Pre- and post-surgery echocardiography measurements were collected, and adverse LVR was defined as a>15% increase in left ventricular end-diastolic volume or >10% decrease in left ventricular ejection fraction. Binary regression analysis was used to determine independent predictors of poor left ventricular remodeling. Results The variables associated with adverse LVR in this study were LVGLS (P<0.001, odds ratio: 1.996, 95% CI: 1.394–2.856) and MD (P=0.011, odds ratio: 1.031, 95% CI: 1.007–1.055). The poorly reconstructed group had lower absolute values of LVGLS and higher MD than the healthy control group and the non-poorly reconstructed group. A LVGLS cutoff of −15.0% was the best predictor for patients with poorly reconstructed LVR (sensitivity: 75.7%; specificity: 100.0%; AUC: 0.93), and a MD cutoff of 63.8ms was the best predictor (sensitivity: 63.8%; specificity: 98.6%; AUC: 0.88). Conclusion Speckle tracking echocardiography has potential value for predicting the progression of adverse LVR and for identifying non-responders among patients with RMS undergoing surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Speckle-Tracking Echocardiography Predicts Adverse Left Ventricular Remodeling After Valve Replacement in Rheumatic Mitral Stenosis

Zhang,

Cai

et al. 2023

TCRM

View full text Add to dashboard Cite

show abstract

“…Post intervention LV dysfunction is estimated to be seen in 16.8% of patients (26). Hence, prediction of improvement in LV function is important in prognostication of patients.…”

Section: Predictors Of Improvement In LV Functionmentioning

confidence: 99%

Effect of percutaneous balloon mitral valvuloplasty on left ventricular function in rheumatic mitral stenosis

Singh¹,

Prajapati²,

Parhikh³

et al. 2022

HVT

View full text Add to dashboard Cite

Objective: Patients with rheumatic mitral stenosis, despite having normal left ventricular ejection fraction (LV EF), have ventricular dysfunction in the form of impaired longitudinal excursion. Tissue Doppler velocity is a useful indicator for assessment of long-axis ventricular shortening and lengthening. The aim of our study was to evaluate the effect of percutaneous balloon mitral valvuloplasty (PBMV) on LV function in rheumatic MS and to study echocardiographic parameters with M-Mode and Tissue Doppler Imaging pre PBMV, post PBMV and on follow-up to determine predictors of LV function. Methods: We analysed 52 patients with severe mitral stenosis with normal LV EF, who underwent PBMV at our institute. Baseline parameters of LV function were compared with immediate post PBMV and at three months follow up. Results:The mean age of the patients was 33.73 (10.87) years with female preponderance. The mean mitral valve area before PBMV was 0.92 (0.13) cm 2 which increased to 1.65 (0.21) cm 2 after PBMV and at 3 month it was 1.61 (0.23) cm 2 (p<0.001). LVEF before PBMV by modified Simpson's method was 55.45 (8.44)% and after PBMV, it was 55. 58 (3.46)% and at 3 month it was 56.62 (2.46)% (p>0.05). Mitral valve E' was 8.71 (1.54) cm/s which increased to 10.13 (1.68) cm/s post PBMV and at 3 month it was 10.83 (1.34) cm/s (p<0.001).. Mitral annular systolic velocity (MASV), before PBMV was 7.90 (0.96) cm/s which increased to 9.31 (1.68) cm/s after PBMV and at 3 month it was 10.13 (0.96) cm/s (p<0.001). Myocardial performance index (MPI) before PBMV was 0.54 (0.48) which decreased post PBMV to 0.47 (0.06) and at 3 month it was 0.38 (0.04) (p=0.01). Pre PBMV MPI value <0.48 predicted improvement in LV function (sensitivity: 81%, specificity: 58.1%). Conclusion: Thus, PBMV leads to improvement in LV function in patients with severe MS with normal LV EF.

show abstract

Left Ventricular Remodeling Shortly after Open Mitral Valve Replacement for Rheumatic Mitral Stenosis

Cited by 2 publications

References 21 publications

Speckle-Tracking Echocardiography Predicts Adverse Left Ventricular Remodeling After Valve Replacement in Rheumatic Mitral Stenosis

Speckle-Tracking Echocardiography Predicts Adverse Left Ventricular Remodeling After Valve Replacement in Rheumatic Mitral Stenosis

Effect of percutaneous balloon mitral valvuloplasty on left ventricular function in rheumatic mitral stenosis

Contact Info

Product

Resources

About