Preoperative pulmonary hypertension is associated with postoperative left ventricular dysfunction in chronic organic mitral regurgitation: an echocardiographic and hemodynamic study.
BACKGROUND
Some degree of pulmonary hypertension (PHTN) is common in patients with chronic mitral regurgitation. The aim of this study was to determine whether preoperative PHTN is associated with postoperative left ventricular (LV) dysfunction.


METHODS
The study included 79 patients with chronic organic mitral regurgitation. Preoperative and postoperative LV function was assessed by echocardiography. Preoperative and postoperative hemodynamics were evaluated by a pulmonary artery catheter.


RESULTS
Pulmonary artery systolic pressure decreased postoperatively (pre 49 +/- 14 vs. post 36 +/- 11 mm Hg, P < .01). Postoperative LV ejection fraction was significantly reduced in patients with preoperative PHTN (pre 61 +/- 11% vs post 49 +/- 12%, P < .01). A stepwise multivariate regression analysis showed that preoperative pulmonary artery systolic pressure and LV end-systolic dimension were independent predictors of postoperative LV ejection fraction (r = -0.53, P < .001, and r = -0.34, P < .05, respectively).


CONCLUSIONS
Preoperative PHTN is associated with postoperative LV dysfunction in patients with chronic organic mitral regurgitation undergoing mitral valve operation.
Yang
Hua
H
Division of Cardiology, Division of Cardiothoracic Surgery, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0580, USA.
Davidson
William R
WR
Chambers
Charles E
CE
Pae
Walter E
WE
Sun
Benjamin
B
Campbell
David B
DB
Pu
Min
M
D002908:Chronic Disease; D015150:Echocardiography, Doppler / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D010414:Pennsylvania / Q000453:epidemiology; D011182:Postoperative Care / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000706:statistics & numerical data; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013223:Statistics as Topic; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*