Key result
Preoperative mitral annulus diameter ≥45 mm is linked to ~56% higher odds of MR progression.
Why the study?
The study aimed to identify predictors of naive functional MR progression in patients with severe left ventricular dilatation undergoing isolated surgical correction of chronic aortic regurgitation.
Does preoperative mitral annular dilatation predict the progression of functional mitral regurgitation in patients with severe left ventricular dilatation undergoing isolated surgical correction of chronic aortic regurgitation?
Cohort (n=80)
Does preoperative mitral annular dilatation predict the progression of functional mitral regurgitation in patients with severe left ventricular dilatation undergoing isolated surgical correction of chronic aortic regurgitation?
Answers are grounded in this paper and cite their sources.
In patients with chronic aortic regurgitation and severe LV dilatation (LVEDV ≥ 250 ml), a preoperative mitral annulus diameter ≥ 45 mm identifies those at risk for functional mitral regurgitation progression despite isolated aortic valve correction.
Objective. To identify predictors of naive functional mitral regurgitation (MR) progression in patients with severe left ventricular dilatation after isolated correction of aortic valve disease. Material and methods. The study included 80 patients with left ventricular end-diastolic volume (LVEDV) ≥ 250 ml due to chronic AI with functional MR. In all patients, AI was the only primary factor of left ventricular remodeling. Surgical treatment of AI was performed using the David and Bentall-DeBono techniques, as well as aortic valve replacement and isolated aortic valve leaflet repair. Functional MR was assessed using transthoracic echocardiography. We evaluated MR and potential predictors 1—10 days before surgery, 7—10 days after surgery, and at least 6 months after surgical treatment. Results. Preoperative mitral annulus diameter (MAD) ≥ 45 mm is an independent predictor of long-term MR progression with LVEDV ≥ 250 ml in all groups with (OR 1.560, CI 1.033—2.358, p=0.035). The MAD/left ventricular end-diastolic diameter (LVEDD) ratio ≥ 0.539 before surgery is a significant predictor of postoperative MR progression (AUC=0.734; 95% CI: 0.562—0.905, p=0.011). The MAD/left ventricular end-systolic diameter (LVESD) ratio ≥ 0.833 before surgery is a significant predictor of MR progression (AUC=0.698; 95% CI: 0.522—0.875, p=0.031). Conclusion. Functional MR following chronic AI may progress after correction of aortic valve disease in patients with severe mitral annular dilatation.
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Bulynin et al. (2026) conducted a cohort in Chronic aortic regurgitation with severe left ventricular dilatation (LVEDV ≥ 250 ml) and naive functional mitral regurgitation (n=80). Preoperative mitral annulus diameter (MAD) ≥ 45 mm vs. Preoperative mitral annulus diameter (MAD) < 45 mm was evaluated on Long-term progression of functional mitral regurgitation (MR) after isolated surgical correction of chronic aortic regurgitation (OR 1.560, 95% CI 1.033-2.358, p=0.035). Preoperative mitral annulus diameter ≥ 45 mm independently predicted long-term functional MR progression after surgical correction of aortic regurgitation.
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