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Title: | The prognostic value of changes in pulmonary vein flow patterns after surgical repair for primary mitral regurgitation | Authors: | Yedidya, Idit STASSEN, Jan Butcher, Steele van Wijngaarden, Aniek L. Wu, Yoska van der Bijl, Pieter Marsan, Nina Ajmone Delgado, Victoria Bax, Jeroen |
Issue Date: | 2024 | Publisher: | ELSEVIER IRELAND LTD | Source: | International Journal of Cardiology (print), 414 (Art N° 132414) | Abstract: | Background: The pulmonary vein (PV) flow pattern is influenced by the presence of mitral regurgitation (MR). After a successful reduction in MR severity, the pattern is expected to be changed. We aimed to evaluate the prognostic value of a change in the PV flow pattern in patients with primary MR undergoing mitral valve repair (MVR). Methods: The PV flow pattern was assessed with transthoracic echocardiography in 216 patients (age 65 [IQR 56-72] years, 70% male) with primary MR before and after surgical MVR. The population was divided according to a change in the PV flow pattern following MVR into 'improvers' and 'non-improvers'. Results: Nonimprovers (15%) had a higher prevalence of paroxysmal AF at baseline (46% vs. 22%, p = 0.004), left ventricular dysfunction (LVEF <= 60%) (39% vs. 21%, p = 0.020), and had lower systolic pulmonary artery pressure (28[IQR 25-38] vs. 35[IQR 26-48] mmHg, p = 0.018) compared to improvers (85%). After a median follow-up of 83[IQR 43-140] months, 26(12%) patients died. Non-improvers had higher mortality rates than improvers (p = 0.009). On multivariable Cox regression analysis, a lack of improvement in the PV flow pattern remained independently associated with all-cause mortality (HR 2.322, 95% CI 1.140 to 4.729, P = 0.020). Conclusion: A lack of improvement in the PV flow pattern is independently associated with worse long-term survival in patients with primary MR undergoing MVR. | Notes: | Yedidya, I (corresponding author), Heart Lung Ctr, Dept Cardiol, Albinusdreef 2, NL-2300 RC Leiden, Netherlands. I.Yedidya@lumc.nl |
Keywords: | Pulmonary vein flow changes;Prognosis;Primary mitral regurgitation. | Document URI: | http://hdl.handle.net/1942/43693 | ISSN: | 0167-5273 | e-ISSN: | 1874-1754 | DOI: | 10.1016/j.ijcard.2024.132414 | ISI #: | 001291758500001 | Rights: | 2024 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/). | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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The prognostic value of changes in pulmonary vein flow patterns after surgical repair for primary mitral regurgitation.pdf | Published version | 1.06 MB | Adobe PDF | View/Open |
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