Myocardial performance index as predictor of adverse outcomes following mitral valve surgery.
OBJECTIVE
We aim to determine whether the myocardial performance index, will be a good predictor of adverse outcomes following mitral valve surgery.


METHODS
We prospectively measured pre-operative myocardial performance index in 22 consecutive patients, with moderate to severe mitral insufficiency, undergoing corrective mitral valve surgery. The primary endpoint was predefined as either peri-operative death or congestive heart failure.


RESULTS
The primary endpoint occurred in nine patients. Five of the six patients with myocardial performance index >or=0.7 had primary endpoints. Chi-square testing demonstrated that the primary endpoint was significantly associated with advanced age (>or=70 years) and myocardial performance index >or=0.7 (P=0.003 and 0.01 respectively). There was a trend towards significant association of depressed left ventricle ejection fraction (left ventricle ejection fraction <or=40%) and the primary endpoint (P=0.09). Although left ventricle ejection fraction <or=40% was more sensitive in predicting the primary endpoint, it has lower specificity, accuracy and predictive values than myocardial performance index >or=0.7.


CONCLUSIONS
Our results suggest that myocardial performance index is a potentially useful predictor of increased risk of peri-operative death or congestive heart failure, in patients with moderate-severe mitral insufficiency undergoing corrective mitral valve surgery. In conjunction with left ventricle ejection fraction, it may be helpful in the pre-operative prognostication of these patients.
Division of Cardiology, Montreal General Hospital, Montreal, Quebec, Canada.
M
M
Al-Mukhaini
S
S
Argentin
J-F
JF
Morin
C
C
Benny
D
D
Cusson
T
T
Huynh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D009200:Myocardial Contraction / Q000502:physiology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011792:Quebec; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology / Q000601:surgery