[Late changes of the left ventricular function following non-ischemic mitral valve reconstructive surgery].
The aim of the study was to evaluate late changes of left ventricular geometry and function following non-ischemic mitral valve reconstructive surgery.


METHODS
The study included 43 patients with non-ischemic mitral valve incompetence due to mitral valve fiber degeneration, Barlow disease, and endocarditis. Doppler echocardiography was performed prior, 10-14 days and 12 months following mitral valve anuloplasty.


RESULTS
Early after surgery preload reduction resulted in reduction of left ventricular end diastolic diameter index (from 31.7+/-2.8 to 27.9+/-2.4 mm/m(2), p<0.001), end diastolic volume index (from 81.1+/-15.8 to 55.7+/-12.2 ml/m(2), p<0.001). Due to increased afterload left ventricular systolic parameters remained unchanged with decrease in left ventricular ejection fraction (from 57.7+/-7.9 to 48.5+/-3.1%, p<0.001). Late after surgery left ventricular end systolic diameter index decreased from 20.2+/-2.4 to 17.4+/-2.8 mm/m(2) (p<0.001), wall stress - from 44.1+/-10.1 to 35.4+/-7.4 dyn/cm(2) (p<0.001), ejection fraction increased from 48.5+/-3.1 to 56.4+/-4.6% (p<0.001). Reduction of left atrium diameters and systolic pulmonary artery pressure from 46.4+/-13.2 to 37.8+/-4.6 mm Hg st. (p<0.001) were also noted.


CONCLUSIONS
Surgical correction of non-ischemic mitral valve incompetence and reduction of preload result in positive left ventricular remodeling in early postoperative period. At the earliest reduction of left ventricular diastolic parameters is observed and following one year - reduction of left ventricular systolic parameters, left atrium, pulmonary artery pressure, and improvement in left ventricular systolic function.
Ereminiene
Egle
E
Institute for Biomedical Research, Kaunas University of Medicine, Lithuania.
Vaskelyte
Jolanta
J
Benetis
Rimantas
R
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002404:Catheterization; D003627:Data Interpretation, Statistical; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D011651:Pulmonary Artery / Q000502:physiology; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling