Key result
Preoperative echo and CMR moderately predict postoperative LV dysfunction with subgroup risks up to 41%.
Why the study?
The study evaluated the relationship between preoperative LV structural and functional characteristics assessed by Echo and CMR and the risk of postoperative LV dysfunction in primary MR after MV repair surgery.
Does preoperative assessment with echocardiography and cardiac magnetic resonance predict postoperative left ventricular dysfunction in patients with primary mitral regurgitation undergoing mitral valve repair?
Cohort (n=223)
Does preoperative assessment with echocardiography and cardiac magnetic resonance predict postoperative left ventricular dysfunction in patients with primary mitral regurgitation undergoing mitral valve repair?
A stepwise preoperative imaging approach using echocardiography and cardiac magnetic resonance provides moderate ability to risk-stratify patients for postoperative left ventricular dysfunction after mitral valve repair.
Should not yet change preoperative risk assessment; hypothesis-generating for combined imaging stratification in primary mitral regurgitation repair.
BACKGROUND: We evaluated the relationship between preoperative left ventricular (LV) structural and functional characteristics assessed by echocardiography (Echo) and cardiac magnetic resonance (CMR) and the risk of postoperative LV dysfunction in patients with primary mitral regurgitation (MR) undergoing mitral valve (MV) repair surgery. METHODS: We retrospectively studied 223 patients (median age, 60 years; 21% women) with chronic primary MR who underwent preoperative Echo and CMR before MV repair surgery. The primary end point was postoperative LV dysfunction, defined as LV ejection fraction (LVEF) <50% on follow-up Echo. RESULTS: , identified 3 subgroups with distinct rates of postoperative LV dysfunction (9%, 20%, and 41%, respectively). CONCLUSION: In patients with primary MR undergoing MV surgery, preoperative LV characteristics assessed by Echo and CMR showed only moderate ability to identify those at higher risk of postoperative LV dysfunction. A stepwise approach using Echo indLVESD followed by CMR LVEF may help identify subgroups at differing risk levels. These exploratory findings require confirmation in larger prospective studies.
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Altes et al. (2025) conducted a cohort in Primary mitral regurgitation (n=223). Preoperative echocardiography and cardiac magnetic resonance was evaluated on Postoperative LV dysfunction (LVEF <50% on follow-up echocardiography). Preoperative echocardiography and cardiac magnetic resonance showed moderate ability to identify risk of postoperative LV dysfunction, identifying subgroups with 9%, 20%, and 41% risk.
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