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Left ventricular diastolic function after restrictive mitral ring annuloplasty in chronic ischemic mitral regurgitation and its predictive value on outcome and recurrence of regurgitation

2008; Elsevier BV; Volume: 132; Issue: 3 Linguagem: Inglês

10.1016/j.ijcard.2007.12.058

1874-1754

Sandro Gelsomino, Roberto Lorusso, Giuseppe Billè, Carlo Rostagno, Giuseppe De Cicco, Stefano Romagnoli, Cristina Porciani, Cecilia Tetta, Pierluigi Stefàno, Gian Franco Gensini,

Cardiac Imaging and Diagnostics

This study was aimed at exploring the predictive value of diastolic function on clinical outcome and recurrence of ischemic mitral regurgitation following combined undersized mitral annuloplasty (UMRA) and coronary artery bypass grafting (CABG).Two hundred-thirty-four patients with chronic ischemic mitral regurgitation (CIMR) who survived combined UMRA and CABG between September 2001 and September 2007, were divided into four groups on the basis of baseline deceleration time (DT) and systolic-diastolic pulmonary venous flow ratio (S/D): Group 1, normal (n=48), Group 2, impaired relaxation (n=61), Group 3, pseudonormal (n=60) and Group 4, restrictive (n=65). Echocardiograms were performed, preoperatively, at discharge and at follow-up appointments (early, 6 months [interquartile range, IQR] 3-8 months; late, 38 months [IQR17-53 months]).Early mortality rate was highest in the restrictive group (9.2%, p or=2 (p<0.001). Furthermore, DT<140 ms and S/D<0.80 were independent predictors of early (p<0.001 and 0.004, respectively) and late (both p<0.001) death. Finally DT<140 ms was the only diastolic independent predictor of MR recurrence (p<0.001).In patients with CIMR undergoing combined CABG and UMRA restrictive LV diastolic filling pattern is an important preoperative marker of high early and late death and recurrence of MR.