Tissue doppler imaging predicts left ventricular reverse remodeling after surgery for mitral regurgitation

Young Song, Sak Lee, Younglan Kwak, ChiYoung Shim, Byung Chul Chang, Jae Kwang Shim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Tissue Doppler imaging of systolic mitral annular velocity (Sm) has been shown to be able to detect early left ventricular (LV) dysfunction in the presence of chronic severe mitral regurgitation with normal left ventricular ejection fraction. We investigated the association of preoperative Sm with LV reverse remodeling after mitral valve surgery. Methods Patients with chronic severe organic mitral regurgitation exhibiting LV ejection fraction greater than 60% were enrolled. The LV reverse remodeling was defined as changes of LV mass index of 20% or greater postoperatively. The primary endpoints were to compare the changes of LV mass index in relation to the tertile distribution of the Sm and evaluate predictive value of the Sm for LV reverse remodeling. Results In all, 169 patients were analyzed. The changes of LV mass index in the first tertile was 25% (11% to 37) compared with 34% (19% to 43%) in the second tertile and 34% (26% to 47%) in the third tertile (p = 0.003). On multivariate analysis, Sm was the only independent predictor of LV reverse remodeling (odds ratio 1.77, 95% confidence interval: 1.30 to 2.40, p < 0.001). The optimal cutoff value measured by receiver-operating characteristic curve analysis was 7 cm/s of Sm (area under the curve 0.721, 95% confidence interval: 0.64 to 0.80, p < 0.001). Conclusions In patients with severe mitral regurgitation exhibiting LV ejection fraction greater than 60%, surgery may be considered before the Sm is decreased below 7 cm/s to achieve favorable LV reverse remodeling.

Original languageEnglish
Pages (from-to)2109-2115
Number of pages7
JournalAnnals of Thoracic Surgery
Volume96
Issue number6
DOIs
Publication statusPublished - 2013 Dec 1

Fingerprint

Ventricular Remodeling
Mitral Valve Insufficiency
Stroke Volume
Confidence Intervals
Left Ventricular Dysfunction
Mitral Valve
ROC Curve
Area Under Curve
Multivariate Analysis
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

@article{28c97a3cdaca46d48846027597dbcdbf,
title = "Tissue doppler imaging predicts left ventricular reverse remodeling after surgery for mitral regurgitation",
abstract = "Background Tissue Doppler imaging of systolic mitral annular velocity (Sm) has been shown to be able to detect early left ventricular (LV) dysfunction in the presence of chronic severe mitral regurgitation with normal left ventricular ejection fraction. We investigated the association of preoperative Sm with LV reverse remodeling after mitral valve surgery. Methods Patients with chronic severe organic mitral regurgitation exhibiting LV ejection fraction greater than 60{\%} were enrolled. The LV reverse remodeling was defined as changes of LV mass index of 20{\%} or greater postoperatively. The primary endpoints were to compare the changes of LV mass index in relation to the tertile distribution of the Sm and evaluate predictive value of the Sm for LV reverse remodeling. Results In all, 169 patients were analyzed. The changes of LV mass index in the first tertile was 25{\%} (11{\%} to 37) compared with 34{\%} (19{\%} to 43{\%}) in the second tertile and 34{\%} (26{\%} to 47{\%}) in the third tertile (p = 0.003). On multivariate analysis, Sm was the only independent predictor of LV reverse remodeling (odds ratio 1.77, 95{\%} confidence interval: 1.30 to 2.40, p < 0.001). The optimal cutoff value measured by receiver-operating characteristic curve analysis was 7 cm/s of Sm (area under the curve 0.721, 95{\%} confidence interval: 0.64 to 0.80, p < 0.001). Conclusions In patients with severe mitral regurgitation exhibiting LV ejection fraction greater than 60{\%}, surgery may be considered before the Sm is decreased below 7 cm/s to achieve favorable LV reverse remodeling.",
author = "Young Song and Sak Lee and Younglan Kwak and ChiYoung Shim and Chang, {Byung Chul} and Shim, {Jae Kwang}",
year = "2013",
month = "12",
day = "1",
doi = "10.1016/j.athoracsur.2013.06.087",
language = "English",
volume = "96",
pages = "2109--2115",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "6",

}

Tissue doppler imaging predicts left ventricular reverse remodeling after surgery for mitral regurgitation. / Song, Young; Lee, Sak; Kwak, Younglan; Shim, ChiYoung; Chang, Byung Chul; Shim, Jae Kwang.

In: Annals of Thoracic Surgery, Vol. 96, No. 6, 01.12.2013, p. 2109-2115.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Tissue doppler imaging predicts left ventricular reverse remodeling after surgery for mitral regurgitation

AU - Song, Young

AU - Lee, Sak

AU - Kwak, Younglan

AU - Shim, ChiYoung

AU - Chang, Byung Chul

AU - Shim, Jae Kwang

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Background Tissue Doppler imaging of systolic mitral annular velocity (Sm) has been shown to be able to detect early left ventricular (LV) dysfunction in the presence of chronic severe mitral regurgitation with normal left ventricular ejection fraction. We investigated the association of preoperative Sm with LV reverse remodeling after mitral valve surgery. Methods Patients with chronic severe organic mitral regurgitation exhibiting LV ejection fraction greater than 60% were enrolled. The LV reverse remodeling was defined as changes of LV mass index of 20% or greater postoperatively. The primary endpoints were to compare the changes of LV mass index in relation to the tertile distribution of the Sm and evaluate predictive value of the Sm for LV reverse remodeling. Results In all, 169 patients were analyzed. The changes of LV mass index in the first tertile was 25% (11% to 37) compared with 34% (19% to 43%) in the second tertile and 34% (26% to 47%) in the third tertile (p = 0.003). On multivariate analysis, Sm was the only independent predictor of LV reverse remodeling (odds ratio 1.77, 95% confidence interval: 1.30 to 2.40, p < 0.001). The optimal cutoff value measured by receiver-operating characteristic curve analysis was 7 cm/s of Sm (area under the curve 0.721, 95% confidence interval: 0.64 to 0.80, p < 0.001). Conclusions In patients with severe mitral regurgitation exhibiting LV ejection fraction greater than 60%, surgery may be considered before the Sm is decreased below 7 cm/s to achieve favorable LV reverse remodeling.

AB - Background Tissue Doppler imaging of systolic mitral annular velocity (Sm) has been shown to be able to detect early left ventricular (LV) dysfunction in the presence of chronic severe mitral regurgitation with normal left ventricular ejection fraction. We investigated the association of preoperative Sm with LV reverse remodeling after mitral valve surgery. Methods Patients with chronic severe organic mitral regurgitation exhibiting LV ejection fraction greater than 60% were enrolled. The LV reverse remodeling was defined as changes of LV mass index of 20% or greater postoperatively. The primary endpoints were to compare the changes of LV mass index in relation to the tertile distribution of the Sm and evaluate predictive value of the Sm for LV reverse remodeling. Results In all, 169 patients were analyzed. The changes of LV mass index in the first tertile was 25% (11% to 37) compared with 34% (19% to 43%) in the second tertile and 34% (26% to 47%) in the third tertile (p = 0.003). On multivariate analysis, Sm was the only independent predictor of LV reverse remodeling (odds ratio 1.77, 95% confidence interval: 1.30 to 2.40, p < 0.001). The optimal cutoff value measured by receiver-operating characteristic curve analysis was 7 cm/s of Sm (area under the curve 0.721, 95% confidence interval: 0.64 to 0.80, p < 0.001). Conclusions In patients with severe mitral regurgitation exhibiting LV ejection fraction greater than 60%, surgery may be considered before the Sm is decreased below 7 cm/s to achieve favorable LV reverse remodeling.

UR - http://www.scopus.com/inward/record.url?scp=84889258632&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889258632&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2013.06.087

DO - 10.1016/j.athoracsur.2013.06.087

M3 - Article

VL - 96

SP - 2109

EP - 2115

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 6

ER -