Key result
Postoperative LVEF showed a long-term downward trend in RHD patients with preoperative LVEF <50% after combined valve replacement, whereas it plateaued in those with LVEF ≥50% (p < .001).
Why the study?
The authors sought to identify short- and long-term changes in postoperative left ventricular systolic function in patients with rheumatic heart disease undergoing combined aortic and mitral valve replacement.
Does preoperative LVEF predict long-term postoperative changes in left ventricular systolic function in patients with rheumatic heart disease undergoing combined aortic and mitral valve replacement?
Cohort (n=146)
Does preoperative LVEF predict long-term postoperative changes in left ventricular systolic function in patients with rheumatic heart disease undergoing combined aortic and mitral valve replacement?
p-value: p=< .001
In patients with rheumatic heart disease undergoing combined aortic and mitral valve replacement, those with reduced preoperative LVEF experience a long-term decline in postoperative LVEF after an initial improvement, highlighting the need for closer long-term monitoring in this subgroup.
BACKGROUNDS: We sought to identify short- and long-term changes in postoperative left ventricular systolic function in patients with rheumatic heart disease (RHD) who underwent combined aortic and mitral valve replacement. METHODS: We analyzed 146 patients according to their preoperative left ventricular ejection fraction (LVEF) (113 with preoperative LVEF ≥50% and 33 with preoperative LVEF <50%). A restricted cubic spline model was used to assess the effect of time on the postoperative changes in echocardiographic parameters. RESULTS: There were no significant difference in preoperative and immediately postoperative LVEF before discharge in either group. During median follow-up of 3.2 years (interquartile range: 1.3-4.7 years) after surgery, postoperative LVEF increased slightly and then plateaued in patients with preoperative LVEF ≥50%, whereas it increased over 3-4 years after surgery and then gradually decreased in patients with preoperative LVEF <50% (p < .001). CONCLUSION: Long-term postoperative LVEF showed a downward trend in RHD patients with reduced preoperative LVEF, whereas it reached a plateau in RHD patients with normal preoperative LVEF.
No takes yet. Share an insight, caveat, or question.
An et al. (2021) conducted a cohort in Rheumatic heart disease (n=146). Preoperative LVEF <50% vs. Preoperative LVEF ≥50% was evaluated on Postoperative changes in left ventricular ejection fraction (LVEF) (p=< .001). Postoperative LVEF showed a long-term downward trend in RHD patients with preoperative LVEF <50% after combined valve replacement, whereas it plateaued in those with LVEF ≥50% (p < .001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: