Right ventricular dilatation predicts survival after mitral valve repair in patients with impaired left ventricular systolic function.
OBJECTIVE
The prognostic value of the right ventricular parameters in patients with heart failure (HF) is well documented, but the data on patients undergoing mitral valve repair are lacking.


RESULTS
The association between pre-operative right ventricular dilatation and outcome was studied in 70 consecutive patients with HF who underwent elective mitral valve repair. Mean age was 67 years, 71% were men, mean pre-operative NYHA class was 2.8, mean pre-operative ejection fraction was 31%, and 47% had atrial fibrillation. The ischaemic cardiomyopathy (ICM) was the cause of HF in 32% of the patients. Perioperative mortality was 7.1% by a median logistic Euroscore of 7.5 (range 1.3-47.5). During a mean follow-up of 887 days, 35% of the patients reached the combined endpoint of overall mortality or transplantation. Reoperation was performed in four patients. One and 3 years survival rates were 88% and 72%, respectively. By multivariate Cox analysis, right ventricular dilatation, ICM, and age significantly predicted the outcome.


CONCLUSIONS
Right ventricular dilatation is an important modulator of outcome in patients with HF and mitral regurgitation.
Chrustowicz
Anton
A
Department of Internal Medicine, Cardiology and Intensive Care, University of Technology, Heart Centre Dresden, Fetscherstrasse 76, D-01307 Dresden, Germany. anton_chrustowicz@yahoo.de
Simonis
Gregor
G
Matschke
Klaus
K
Strasser
Ruth H
RH
Gackowski
Andrzej
A
D000368:Aged; D005260:Female; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D006350:Heart Valve Prosthesis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D016278:Ventricular Function, Right