Left ventricular remodelling early after surgical correction of mitral regurgitation: Stroke volume maintenance

E. A. Ashikhmina, Hartzell V Schaff, R. M. Suri, Maurice E Sarano, M. D. Abel

Research output: Contribution to journalArticle

Abstract

Aim. Mitral valve surgery results in the left ventricular (LV) remodelling and adjustment to the new preload and afterload. This study evaluated the dynamics of LV geometry and function immediately after surgical correction of mitral valve (MV) degenerative prolapse. Material and methods. This prospective study included 40 patients: 25 after MV surgery and 15 after coronary artery bypass graft surgery. The latter group served as controls, in order to assess potential impact of cardiopulmonary bypass and cardioplegic arrest on LV function. All participants underwent intraoperative transesophageal echocardiography, before and after cardiopulmonary bypass, after protamine infusion and hemodynamic stabilisation. Simultaneous pulmonary catheterisation ensured that the echocardiographic data were obtained in similar hemodynamic conditions. Results. Immediately after MV surgery, LV fractional area change decreased from 65±7% to 52±% (p<0,001). End-diastolic LV area decreased from 21,3±5,3 to 19,4±4,5 cm 2 (p=0,005), while end-systolic LV area increased from 7,5±2,3 to 9,3±2,5 cm 2 (p<0,001). Stroke volume, measured by the thermodilution method, did not change (54±12% and 57±0%; p=0,5). In the control group, LV fractional area change (54±12% and 57±10%; p=0,19), end-diastolic LV area (16,6±6,2 and 15,7±5,0 cm 2; p=0,32), and stroke volume (72±29 and 65±19 ml; p=0,15) were similar before and after cardiopulmonary bypass; there was only some reduction in end-systolic LV area (7,9±4,4 and 6,9±3,2 cm 2; p=0,03). Conclusion. Early after MR surgery, LV fractional area change statistically decreased, primarily due to an increase in end-systolic LV dimensions. It could be one of the compensatory mechanisms to prevent acute increase in stroke volume and subsequent MR after MV surgery.

Original languageEnglish (US)
Pages (from-to)43-49
Number of pages7
JournalRussian Journal of Cardiology
Volume99
Issue number1
StatePublished - 2013

Fingerprint

Ventricular Remodeling
Mitral Valve Insufficiency
Stroke Volume
Mitral Valve
Maintenance
Cardiopulmonary Bypass
Left Ventricular Function
Hemodynamics
Thermodilution
Mitral Valve Prolapse
Protamines
Transesophageal Echocardiography
Coronary Artery Bypass
Catheterization
Prospective Studies
Transplants
Lung
Control Groups

Keywords

  • Left ventricular remodelling
  • Mitral valve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Left ventricular remodelling early after surgical correction of mitral regurgitation : Stroke volume maintenance. / Ashikhmina, E. A.; Schaff, Hartzell V; Suri, R. M.; Sarano, Maurice E; Abel, M. D.

In: Russian Journal of Cardiology, Vol. 99, No. 1, 2013, p. 43-49.

Research output: Contribution to journalArticle

@article{0cacc9ddb8724e06bd727e2186bb40fd,
title = "Left ventricular remodelling early after surgical correction of mitral regurgitation: Stroke volume maintenance",
abstract = "Aim. Mitral valve surgery results in the left ventricular (LV) remodelling and adjustment to the new preload and afterload. This study evaluated the dynamics of LV geometry and function immediately after surgical correction of mitral valve (MV) degenerative prolapse. Material and methods. This prospective study included 40 patients: 25 after MV surgery and 15 after coronary artery bypass graft surgery. The latter group served as controls, in order to assess potential impact of cardiopulmonary bypass and cardioplegic arrest on LV function. All participants underwent intraoperative transesophageal echocardiography, before and after cardiopulmonary bypass, after protamine infusion and hemodynamic stabilisation. Simultaneous pulmonary catheterisation ensured that the echocardiographic data were obtained in similar hemodynamic conditions. Results. Immediately after MV surgery, LV fractional area change decreased from 65±7{\%} to 52±{\%} (p<0,001). End-diastolic LV area decreased from 21,3±5,3 to 19,4±4,5 cm 2 (p=0,005), while end-systolic LV area increased from 7,5±2,3 to 9,3±2,5 cm 2 (p<0,001). Stroke volume, measured by the thermodilution method, did not change (54±12{\%} and 57±0{\%}; p=0,5). In the control group, LV fractional area change (54±12{\%} and 57±10{\%}; p=0,19), end-diastolic LV area (16,6±6,2 and 15,7±5,0 cm 2; p=0,32), and stroke volume (72±29 and 65±19 ml; p=0,15) were similar before and after cardiopulmonary bypass; there was only some reduction in end-systolic LV area (7,9±4,4 and 6,9±3,2 cm 2; p=0,03). Conclusion. Early after MR surgery, LV fractional area change statistically decreased, primarily due to an increase in end-systolic LV dimensions. It could be one of the compensatory mechanisms to prevent acute increase in stroke volume and subsequent MR after MV surgery.",
keywords = "Left ventricular remodelling, Mitral valve",
author = "Ashikhmina, {E. A.} and Schaff, {Hartzell V} and Suri, {R. M.} and Sarano, {Maurice E} and Abel, {M. D.}",
year = "2013",
language = "English (US)",
volume = "99",
pages = "43--49",
journal = "Russian Journal of Cardiology",
issn = "1560-4071",
publisher = "Russian Society of Cardiology",
number = "1",

}

TY - JOUR

T1 - Left ventricular remodelling early after surgical correction of mitral regurgitation

T2 - Stroke volume maintenance

AU - Ashikhmina, E. A.

AU - Schaff, Hartzell V

AU - Suri, R. M.

AU - Sarano, Maurice E

AU - Abel, M. D.

PY - 2013

Y1 - 2013

N2 - Aim. Mitral valve surgery results in the left ventricular (LV) remodelling and adjustment to the new preload and afterload. This study evaluated the dynamics of LV geometry and function immediately after surgical correction of mitral valve (MV) degenerative prolapse. Material and methods. This prospective study included 40 patients: 25 after MV surgery and 15 after coronary artery bypass graft surgery. The latter group served as controls, in order to assess potential impact of cardiopulmonary bypass and cardioplegic arrest on LV function. All participants underwent intraoperative transesophageal echocardiography, before and after cardiopulmonary bypass, after protamine infusion and hemodynamic stabilisation. Simultaneous pulmonary catheterisation ensured that the echocardiographic data were obtained in similar hemodynamic conditions. Results. Immediately after MV surgery, LV fractional area change decreased from 65±7% to 52±% (p<0,001). End-diastolic LV area decreased from 21,3±5,3 to 19,4±4,5 cm 2 (p=0,005), while end-systolic LV area increased from 7,5±2,3 to 9,3±2,5 cm 2 (p<0,001). Stroke volume, measured by the thermodilution method, did not change (54±12% and 57±0%; p=0,5). In the control group, LV fractional area change (54±12% and 57±10%; p=0,19), end-diastolic LV area (16,6±6,2 and 15,7±5,0 cm 2; p=0,32), and stroke volume (72±29 and 65±19 ml; p=0,15) were similar before and after cardiopulmonary bypass; there was only some reduction in end-systolic LV area (7,9±4,4 and 6,9±3,2 cm 2; p=0,03). Conclusion. Early after MR surgery, LV fractional area change statistically decreased, primarily due to an increase in end-systolic LV dimensions. It could be one of the compensatory mechanisms to prevent acute increase in stroke volume and subsequent MR after MV surgery.

AB - Aim. Mitral valve surgery results in the left ventricular (LV) remodelling and adjustment to the new preload and afterload. This study evaluated the dynamics of LV geometry and function immediately after surgical correction of mitral valve (MV) degenerative prolapse. Material and methods. This prospective study included 40 patients: 25 after MV surgery and 15 after coronary artery bypass graft surgery. The latter group served as controls, in order to assess potential impact of cardiopulmonary bypass and cardioplegic arrest on LV function. All participants underwent intraoperative transesophageal echocardiography, before and after cardiopulmonary bypass, after protamine infusion and hemodynamic stabilisation. Simultaneous pulmonary catheterisation ensured that the echocardiographic data were obtained in similar hemodynamic conditions. Results. Immediately after MV surgery, LV fractional area change decreased from 65±7% to 52±% (p<0,001). End-diastolic LV area decreased from 21,3±5,3 to 19,4±4,5 cm 2 (p=0,005), while end-systolic LV area increased from 7,5±2,3 to 9,3±2,5 cm 2 (p<0,001). Stroke volume, measured by the thermodilution method, did not change (54±12% and 57±0%; p=0,5). In the control group, LV fractional area change (54±12% and 57±10%; p=0,19), end-diastolic LV area (16,6±6,2 and 15,7±5,0 cm 2; p=0,32), and stroke volume (72±29 and 65±19 ml; p=0,15) were similar before and after cardiopulmonary bypass; there was only some reduction in end-systolic LV area (7,9±4,4 and 6,9±3,2 cm 2; p=0,03). Conclusion. Early after MR surgery, LV fractional area change statistically decreased, primarily due to an increase in end-systolic LV dimensions. It could be one of the compensatory mechanisms to prevent acute increase in stroke volume and subsequent MR after MV surgery.

KW - Left ventricular remodelling

KW - Mitral valve

UR - http://www.scopus.com/inward/record.url?scp=84933048709&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84933048709&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:84933048709

VL - 99

SP - 43

EP - 49

JO - Russian Journal of Cardiology

JF - Russian Journal of Cardiology

SN - 1560-4071

IS - 1

ER -