[Left ventricular contractile function and prognosis of surgical treatment in patients with chronic mitral regurgitation].
We assessed the preoperative left ventricular contractile function affected to the postoperative prognosis in 28 patients with chronic mitral regurgitation (MR). The patients were divided into two groups and compared with 11 normal subjects. 21 patients improved clinically after surgery (group-A) and 7 patients died or did not improve with surgery (group-B). Both preoperative end-diastolic volume index (EDVI) and end-systolic volume index (ESVI) were significantly greater in group-B than in group-A (220 +/- 48 vs 162 +/- 48 ml/M2, 143 +/- 50 vs 66 +/- 21 ml/M2, p less than 0.01). Ejection fraction (EF) was lower in group-B than in group-A (0.36 +/- 0.07 vs 0.59 +/- 0.08, p less than 0.01). End-systolic stress (ESS) was higher in group-B than in group-A (250 +/- 38 vs 170 +/- 37 kdyne/cm2, p less than 0.01). ESS/ESVI was lower in group-B than in group-A (1.83 +/- 0.28 vs 2.66 +/- 0.68 kdyne.M2/cm5, p less than 0.01). The ratio of wall thickness to radius at end-systole (h/R) was higher in group-A than in group-B (0.32 +/- 0.13 VS 0.18 +/- 0.05, p less than 0.01). There were significant positive correlation between ESS and ESVI in normal subjects (Y = 2.14X + 78, r = 0.59, p less than 0.05) and in MR (Y = 210 logX - 206, r = 0.81, p less than 0.001). Patients in group-B were distributed rightward on the logarithmic correlation curve in MR. These data indicated more depressed contractility in group-B than group-A.(ABSTRACT TRUNCATED AT 250 WORDS)
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D000328:Adult; D002908:Chronic Disease; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000503:physiopathology* / Q000601:surgery; D009200:Myocardial Contraction; D011379:Prognosis