title: Low-dose dobutamine stress echocardiography cannot predict mitral regurgitation reversibility after coronary artery bypass grafting.
abstract: BACKGROUND
  The ideal management of ischemic mitral regurgitation (MR) remains a clinical dilemma because of the suboptimal available therapeutic options. Recently, new concepts have emerged, pointing to the benefits of a patient selection approach when debating the management of moderate ischemic MR. We investigated the predictability of low-dose dobutamine stress echocardiography (DSE) in selecting candidates for CABG with moderate MR for valve repair.
  
  
  METHODS
  From November 2002 to May 2010, 110 candidates for first-time CABG, who were admitted to the cardiac surgery department in Day General Hospital (Tehran, Iran), were enrolled in the present cross-sectional study. DSE was performed for each case before CABG. Those with positive findings underwent CABG alone and those with negative results underwent concomitant CABG and mitral valve repair. The patients were followed up for a minimum of 60 months.
  
  
  RESULTS
  Of the 110 patients, 47 (42.72%) had positive test results and underwent CABG alone and 63 (57.28%) had negative DSE results and underwent concomitant CABG and mitral valve repair. The MR degree had decreased from 2.8±0.3 preoperatively to 1.46±0.6 early during the hospital stay and 1.9±0.7 during late follow-up in the CABG group. It had decreased from 2.84±0.4 preoperatively to 0.93±0.65 postoperatively but then increased to 1.41±0.9 during late follow-up, for a significant decrease in the combined group (P<.05).
  
  
  CONCLUSIONS
  Despite its utility in selecting CABG patients with moderate ischemic MR for valve repair from a short-term perspective, the use of DSE cannot predict the long-term outcomes of these patients.
authors: Department of Cardiology, Day General Hospital, Tehran, Iran.
authors: Farideh
authors: F
authors: Roshanali
authors: Department of Cardiology, Day General Hospital, Tehran, Iran; Department of Cardiac Surgery, Day General Hospital, Tehran, Iran; Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: ssht84@yahoo.com.
authors: Saeed
authors: S
authors: Shoar
authors: School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
authors: Nasrin
authors: N
authors: Shoar
authors: Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammad
authors: M
authors: Naderan
authors: Department of Cardiology, Day General Hospital, Tehran, Iran.
authors: Farshid
authors: F
authors: Alaeddini
authors: Department of Cardiac Surgery, Day General Hospital, Tehran, Iran.
authors: Mohammad Hossein
authors: MH
authors: Mandegar
mesh_terms: D001026:Coronary Artery Bypass; D003430:Cross-Sectional Studies; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome