Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation.

Enríquez-Sarano, Maurice; Tajik, A. Jamil; Schaff, Hartzell V.; Orszulak, Thomas A.; Bailey, Kent R.; Frye, Robert L.

doi:10.1161/01.cir.90.2.830

Cited by 478 publications

(249 citation statements)

References 55 publications

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“…Acute Coronary Events (GRACE), 12 or PURSUIT 13 scores. In contrast, several small series suggest a more favorable outcome for this group of patients, for both MI 14 and unstable angina (UA).…”

mentioning

confidence: 99%

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Teixeira

Lourenço

António

et al. 2010

Revista Española de Cardiología (English Edition)

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mentioning

confidence: 99%

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Teixeira

Lourenço

António

et al. 2010

Revista Española de Cardiología (English Edition)

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“…Follow-up clinical status was evaluated by a combination of personal or telephone interview and review of medical and vital records. All patients were followed until death or to currently defined predictors of significantly compromised prognosis commonly employed as bases for mitral valve surgery, i.e., new onset of heart failure symptoms (Functional Class≥2) (15), LV ejection fraction rest <10% higher than the lower limit of normal for the testing modality (<60% by echo [16]), new onset atrial fibrillation (17), or echocardiographic LVIDs≥45mm (18), an accepted criterion when the study was performed, and LVIDs>40mm, a more recently suggested criterion for surgery (19) that was not employed at the time this study was undertaken. Echocardiographic effective regurgitant orifice area, recently reported to have significant prognostic impact (20), was not measured in our laboratory during this study.…”

Section: Baseline and Follow-up Assessmentsmentioning

confidence: 99%

Prognostic Value of Exercise Tolerance Testing in Asymptomatic Chronic Nonischemic Mitral Regurgitation

Supino

Borer

Schuleri

et al. 2007

The American Journal of Cardiology

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In many heart diseases, exercise treadmill testing(ETT) has useful functional correlates and/or prognostic value. However, its predictive value in mitral regurgitation(MR) is undefined. To determine whether ETT descriptors predict death or indications for mitral valve surgery among patients with MR, we prospectively followed, for 7±3 endpoint-free years, a cohort of 38 patients with chronic severe nonischemic MR who underwent modified Bruce ETT; all lacked surgical indications at study entry. Their baseline exercise descriptors also were compared with those from 46 patients with severe MR who, at entry, already had reached surgical indications. Endpoints during follow-up among the cohort included sudden death(n=1), heart failure symptoms(n=2), atrial fibrillation(n=4), LVEF<60%(n=2), LV systolic dimensions(IDs)≥45 mm(n=12) and LVIDs>40mm(n=11), LVEF<60%+LVIDs 45 mm(n=3), and heart failure+LVIDs 45mm +LVEF<60%(n=1). In univariate analysis, exercise duration(p=.004), chronotropic response(p=. 007), percent predicted peak heart rate(p=.01) and heart rate recovery(p<.02) predicted events; in multivariate analysis, only exercise duration was predictive(p<.02). Average annual event risk was 5-fold lower(4.62%) with exercise duration≥15 minutes vs. <15 minutes(average annual risk=23.48%, p=.004). Relative risks among patients with and without exercise-inducible ST segment depression were comparable(≤1.3 [NS]) whether defined at entry and/or during follow-up. Exercise duration, but not prevalence of exercise-inducible ST segment depression, was lower(p<. 001) among patients with surgical indications at entry vs. initially endpoint-free patients. In conclusion, among asymptomatic patients with chronic severe nonischemic MR and no objective criteria for operation, progression to surgical indications generally is rapid. However, those with excellent exercise tolerance have a relatively benign course. Exercise-inducible ST segment depression has no prognostic value in this population.We followed, for 7±3 endpoint-free years, 38 patients with chronic severe nonischemic mitral regurgitation (MR) who underwent modified Bruce exercise treadmill testing (ETT) to determine whether ETT descriptors predict death or indications for mitral valve surgery. At study entry, all lacked surgical indications. Exercise duration independently predicted subsequent events; event risks among patients with and without exercise-inducible ST segment depression were comparable. We conclude that among asymptomatic patients with chronic severe nonischemic MR Address for Correspondence: Jeffrey S. Borer, M.D., New York-Presbyterian Hospital New York Weill Cornell Center, 525 East 68 th Street, New York, N.Y. 10021, 212-746-4646=phone, 212-746-8448=fax, canadaD45@aol.com=email Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulti...

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“…Os resultados de estudos comparativos entre reconstrução e troca valvar para insuficiência mitral crônica por degeneração mixomatosa evidenciam superioridade do reparo, principalmente em relação à mortalidade operatória e tardia (12) e função ventricular (12)(13)(14)(15)(16)(17) . A reconstrução mitral isoladamente foi identificada como fator de melhor prognóstico numa série de 409 pacientes, cujos parâmetros clínicos e ecocardiográficos de função ventricular foram estudados por análise multivariada (18) .…”

Section: Comentáriosunclassified

“…Inicialmente, a seleção dos pacientes, onde o caráter evolutivo da doença entre jovens tem sido ressaltado por vários autores. DURAN et al (5) Quanto à função ventricular, vários trabalhos demostram que o retardo da operação acarreta distorção da geometria ventricular, com perda do benefício cirúrgico a longo prazo (18,23,24) . Em nossa casuística, apenas 2 pacientes apresentavam disfunção grave, ambos com doença reumática, sendo que 1 recuperou a função e o outro permaneceu com disfunção moderada até o momento.…”

Section: Comentáriosunclassified

Plastia valvar mitral na doença cardíaca reumática e degeneração mixomatosa: estudo comparativo

Provenzano¹,

Sá²,

Bastos³

et al. 2002

Rev Bras Cir Cardiovasc

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Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation.

Cited by 478 publications

References 55 publications

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Prognostic Value of Exercise Tolerance Testing in Asymptomatic Chronic Nonischemic Mitral Regurgitation

Plastia valvar mitral na doença cardíaca reumática e degeneração mixomatosa: estudo comparativo

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