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Incremental value of three-dimensional echocardiography in the evaluation of left ventricular size in mitral regurgitation: A follow-up study after mitral valve surgery

Citation

Yingchoncharoen, T and Negishi, T and Stanton, T and Marwick, TH, Incremental value of three-dimensional echocardiography in the evaluation of left ventricular size in mitral regurgitation: A follow-up study after mitral valve surgery, Journal of the American Society of Echocardiography, 27, (6) pp. 608-615. ISSN 0894-7317 (2014) [Refereed Article]

Copyright Statement

Copyright 2014 by the American Society of Echocardiography

DOI: doi:10.1016/j.echo.2014.02.009

Abstract

Background: Increased left ventricular (LV) dimensions are an indication for surgery in patients with asymptomatic mitral regurgitation, but M-mode or two-dimensional measurements have known limitations. The aim of this study was to determine the value of three-dimensional echocardiography in predicting postoperative outcomes after mitral surgery.

Methods: Sixty-seven patients with severe asymptomatic or minimally symptomatic mitral regurgitation (69% men; mean age, 62 13 years) who underwent mitral valve surgery from January 2010 to December 2011 were studied. In addition to standard echocardiography, baseline three-dimensional echocardiography was performed for accurate quantification of LV size. Patients were followed over a median time of 1 month (interquartile range, 0-8 months) for postoperative development of atrial fibrillation or LV dysfunction. A multivariate regression analysis was performed to identify associations with events.

Results: Postoperative LV dysfunction developed in 15 patients (22%), and 21 patients (31%) had postoperative atrial fibrillation. There was no association between two-dimensional end-systolic volume index and outcomes (hazard ratio, 1.02; P = .18). Postoperative atrial fibrillation or LV dysfunction was associated with baseline three-dimensional LV end-systolic volume index (hazard ratio, 1.06; 95% confidence interval, 1.04-1.16), independent of age and presence of coronary artery disease. LVESVi ≥ 40 mL/m2 was the best cutoff value to predict postoperative events (sensitivity, 80%; specificity, 85%). After adding LVESVi to a model containing clinical and echocardiographic parameters, net reclassification improvement was 0.27 (95% confidence interval, 0.25-0.29; P = .024).

Conclusions: LVESVi from three-dimensional echocardiography is an independent predictor of postoperative outcomes in patients with severe mitral regurgitation that is incremental to other clinical and echocardiographic variables.

Item Details

Item Type:Refereed Article
Keywords:LV dimensions; LV volume; Mitral regurgitation; Three-dimensional echocardiography; Two-dimensional echocardiography
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, TH (Professor Tom Marwick)
ID Code:96424
Year Published:2014
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-11-05
Last Modified:2017-11-01
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