title: Right ventricular myocardial performance index predicts perioperative mortality or circulatory failure in high-risk valvular surgery.
abstract: BACKGROUND
  The prognostic value of right ventricular myocardial performance index (RVMPI) and right ventricular fractional area change (RVFAC) in mitral or aortic valve surgery has not been well described. The main objective of this study is to assess the prognostic value of RVMPI and RVFAC in predicting postoperative mortality or circulatory failure.
  
  
  METHODS
  RVMPI and RVFAC were prospectively measured after induction of anesthesia using transesophageal echocardiography in 50 consecutive patients undergoing corrective mitral or aortic valve surgery. Univariate and multivariate analyses were performed for the primary clinical end point of in-hospital mortality or circulatory failure.
  
  
  RESULTS
  In the study population, the mean age was 67 +/- 9 years. The primary end point occurred in 17 patients (34%); three patients died, and 14 patients presented signs of circulatory failure. Multivariate regression analysis identified RVMPI and RVFAC as variables of prognostic significance.
  
  
  CONCLUSIONS
  Preoperative RVMPI and RVFAC could have an incremental value in predicting postoperative mortality and morbidity in valvular heart surgery. Future studies are needed to validate these results in a larger population.
authors.affiliation: Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Haddad
authors.forename: André Y
authors.initials: AY
authors.lastname: Denault
authors.forename: Pierre
authors.initials: P
authors.lastname: Couture
authors.forename: Raymond
authors.initials: R
authors.lastname: Cartier
authors.forename: Michel
authors.initials: M
authors.lastname: Pellerin
authors.forename: Sylvie
authors.initials: S
authors.lastname: Levesque
authors.forename: Jean
authors.initials: J
authors.lastname: Lambert
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012720:Severity of Illness Index; D016278:Ventricular Function, Right / Q000502:physiology*