Key result
Mitral valve repair is linked to greater immediate LVEF declines when preoperative LVEF is higher.
Why the study?
The study sought to identify short- and long-term changes in LVEF after mitral valve repair in chronic primary mitral regurgitation according to preoperative LVEF and preoperative LVESD.
Does mitral valve repair alter left ventricular ejection fraction in patients with chronic primary mitral regurgitation?
Cohort (n=461)
Does mitral valve repair alter left ventricular ejection fraction in patients with chronic primary mitral regurgitation?
p-value: p=< 0.001
Postoperative LVEF trajectories after mitral valve repair for primary mitral regurgitation vary significantly based on preoperative LVEF and LVESD, highlighting the importance of baseline ventricular parameters in predicting postoperative ventricular function.
Baseline LVEF may guide post-repair surveillance intensity; leaves open whether it should influence intervention timing in primary MR.
This study sought to identify the short- and long-term changes in left ventricular ejection fraction (LVEF) after mitral valve repair (MVr) in patients with chronic primary mitral regurgitation according to preoperative LVEF (pre-LVEF) and preoperative left ventricular end-systolic diameter (pre-LVESD). This study evaluated 461 patients. Restricted cubic spline regression models were constructed to demonstrate the long-term changes in postoperative LVEF (post-LVEF). The patients were divided into four groups according to pre-LVEF (<50%, 50–60%, 60–70%, and ≥70%). The higher the pre-LVEF was, the greater was the decrease in LVEF immediately after MVr. In the same pre-LVEF range, immediate post-LVEF was lower in patients with pre-LVESD ≥ 40 mm than in those with pre-LVESD < 40 mm. The patterns of long-term changes in post-LVEF differed according to pre-LVEF (p for interaction < 0.001). The long-term post-LVEF reached a plateau of approximately 60% when the pre-LVEF was ≥50%, but it seemed to show a downward trend after reaching a peak at approximately 3–4 years after MVr when the pre-LVEF was ≥70%. The patterns of short- and long-term changes in post-LVEF differed according to pre-LVEF and pre-LVESD values in patients with chronic primary mitral regurgitation after MVr.
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Joung et al. (2021) conducted a cohort in chronic primary mitral regurgitation (n=461). Mitral valve repair vs. Different preoperative LVEF groups (<50%, 50-60%, 60-70%, ≥70%) was evaluated on Short- and long-term changes in postoperative LVEF (p=< 0.001). Mitral valve repair led to greater immediate decreases in postoperative LVEF in patients with higher preoperative LVEF, with long-term patterns differing by baseline LVEF (p for interaction < 0.001).
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