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Early Improvement in Left Atrial Remodeling and / Function after Mitral Valve Repair or Replacement in / Organic Symptomatic Mitral Regurgitation Assessed / by Three-Dimensional Echocardiography
Le Bihan, David C S; Togna, Dorival Julio Della; Barretto, Rodrigo B M; Assef, Jorge Eduardo; Machado, L ucia Romero; Ramos, Auristela Isabel de Oliveira; Abdulmassih Neto, Camilo; Mois es, Valdir Ambrosio; Sousa, Amanda G M R; Campos, Orlando.
Afiliação
  • Le Bihan, David C S; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Togna, Dorival Julio Della; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Barretto, Rodrigo B M; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Assef, Jorge Eduardo; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Machado, L ucia Romero; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Ramos, Auristela Isabel de Oliveira; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Abdulmassih Neto, Camilo; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Mois es, Valdir Ambrosio; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Sousa, Amanda G M R; Instituto Dante Pazzanese de Cardiologia. Sao Paulo. BR
  • Campos, Orlando; Universidade Federal de Sao Paulo. Sao Paulo. BR
Echocardiography ; 32(1): 1122-1130, 2015. ilus
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1062476
Biblioteca responsável: BR79.1
Localização: BR79.1
ABSTRACT
Left atrial (LA) dilation is associated with worse prognosis in various clinical situationsincluding chronic mitral regurgitation (MR). Real time three-dimensional echocardiography (3DE) hasallowed a better assessment of LA volumes and function. Little is known about LA size and function inearly postoperative period in symptomatic patients with chronic organic MR. We aimed to investigatethese aspects.

Methods:

By means of 3DE, 43 patients with symptomatic chronic organic MR were prospectivelystudied before and 30 days after surgery (repair or bioprosthetic valve replacement). Twentysubjects were studied as controls. Maximum (Vol-max), minimum, and preatrial contraction LA volumeswere measured and total, passive, and active LA emptying fractions were calculated.

Results:

Before surgerypatients had higher LA volumes (P < 0.001) but smaller LA emptying fractions than controls(P < 0.01). After surgery there was a reduction in all 3 LA volumes and an increase in active atrial emptyingfraction (AAEF). Multivariate analysis showed that independent predictors of early postoperativeVol-max reduction were preoperative diastolic blood pressure (coefficient = 0.004; P = 0.02), lateralmitral annular early diastolic velocity (e0) (coefficient = 0.023; P = 0.008), and the mean transmitral diastolicgradient increment (coefficient = 0.035; P < 0.001). Furthermore, e0 was also independentlyassociated with AAEF increase (odds ratio = 1.66, P = 0.027).

Conclusion:

Early LA reverse remodelingand functional improvement occur after successful surgery of symptomatic organic MR regardless ofsurgical technique. Diastolic blood pressure and transmitral mean gradient augmentation are variablesnegatively related to Vol-max reduction. Besides, e0 is positively correlated with both Vol-max reductionand AAEF increase.
Assuntos
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Coleções: Bases de dados nacionais / Brasil Base de dados: Sec. Est. Saúde SP / SESSP-IDPCPROD Assunto principal: Ecocardiografia / Átrios do Coração / Insuficiência da Valva Mitral Tipo de estudo: Estudo diagnóstico / Estudo prognóstico Idioma: Inglês Revista: Echocardiography Ano de publicação: 2015 Tipo de documento: Artigo Instituição/País de afiliação: Instituto Dante Pazzanese de Cardiologia/BR / Universidade Federal de Sao Paulo/BR
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Coleções: Bases de dados nacionais / Brasil Base de dados: Sec. Est. Saúde SP / SESSP-IDPCPROD Assunto principal: Ecocardiografia / Átrios do Coração / Insuficiência da Valva Mitral Tipo de estudo: Estudo diagnóstico / Estudo prognóstico Idioma: Inglês Revista: Echocardiography Ano de publicação: 2015 Tipo de documento: Artigo Instituição/País de afiliação: Instituto Dante Pazzanese de Cardiologia/BR / Universidade Federal de Sao Paulo/BR
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