Key result
Mitral valve replacement in patients with severe rheumatic mitral regurgitation led to a significant initial decline in left ventricular ejection fraction, with only 60% of patients recovering to an ejection fraction >55% at six months compared to 87% pre-operatively.
Why the study?
This study evaluated the effects of mitral valve replacement on left ventricular function in patients with severe rheumatic mitral regurgitation.
Does mitral valve replacement improve left ventricular function and clinical outcomes in patients with severe rheumatic mitral regurgitation?
Cohort (n=132)
No
Does mitral valve replacement improve left ventricular function and clinical outcomes in patients with severe rheumatic mitral regurgitation?
Absolute Event Rate: 60% vs 87%
p-value: p=<0.001
In patients with severe rheumatic mitral regurgitation, mitral valve replacement leads to an initial decline in ejection fraction that largely recovers by six months, with preoperative LV end-systolic diameter predicting persistent postoperative LV dysfunction.
LVESD may guide MVR timing in rheumatic MR; leaves open prospective validation before practice change.
INTRODUCTION: This study describes the effects of mitral valve replacement (MVR) on left ventricular (LV) function in patients with severe rheumatic mitral regurgitation (MR). METHODS: This was a retrospective analysis over a nine-year period (2005-2013). Clinical and echocardiographic parameters were recorded pre-operatively and at two weeks, six weeks to three months and six months following MVR. RESULTS: < 0.001). On multivariate analysis, only LVESD emerged as a significant predictor of postoperative LV dysfunction. CONCLUSIONS: In this study, most patients with severe MR presented late with significant impairment of LV function and chamber dilatation that often did not recover fully after surgery. This study emphasises early comprehensive evaluation of severe MR followed by timeous surgery in order to preserve LV function.
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Maharaj et al. (2021) conducted a cohort in Severe rheumatic mitral regurgitation (n=132). Mitral valve replacement vs. Pre-operative baseline was evaluated on Ejection fraction > 55% at 6 months postoperatively (p=<0.001). Mitral valve replacement in patients with severe rheumatic mitral regurgitation led to a significant initial decline in left ventricular ejection fraction, with only 60% of patients recovering to an ejection fraction >55% at six months compared to 87% pre-operatively.
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