title: Right ventricular performance after valve repair for chronic degenerative mitral regurgitation.
abstract: BACKGROUND
  Our aim was to assess right ventricular (RV) performance after mitral valve repair by use of RV focused echocardiography and to evaluate the influence of elevated pulmonary artery systolic pressure (PASP) on RV recovery.
  
  
  METHODS
  Forty consecutive patients undergoing mitral valve repair were prospectively investigated with RV focused echocardiography, including two-dimensional speckle tracking-derived longitudinal strain and measurement of N-terminal protype-B natriuretic peptide levels performed on the day before operation and 6 months postoperatively.
  
  
  RESULTS
  The 30-day mortality was 0%. Overall survival was 97.5% ± 2.5% at 6-month follow-up, and the prevalence of postoperative RV dysfunction was 61% (n = 22). Conventional longitudinal indices of RV function decreased significantly after operation (n = 36): tricuspid annular plane systolic excursion (mean 24 ± 5 mm vs mean 15 ± 3 mm, p < 0.001), systolic peak velocity (mean 14 ± 3 cm/s vs mean 10 ± 2 cm/s, p < 0.001), isovolumic acceleration time (mean 2.5 ± 1.0 cm/s(2) vs mean 2.1 ± 0.7 cm/s(2), p = 0.022), but the RV free wall, septal, and global strain did not change significantly. Patients with preoperative PASP above 50 mm Hg showed a significant change in postoperative RV global strain compared with those whose PASP was 50 mm Hg or below (mean difference 10% ± 30% vs -17% ± 23%, p = 0.033).
  
  
  CONCLUSIONS
  RV dysfunction was common at 6-month follow-up. Pulmonary hypertension, although reversible after operation, had a negative effect on RV function. Speckle tracking-derived RV strain may assist in the prioritization of surgical referrals to avoid biventricular impairment.
authors.affiliation: Department of Cardiothoracic Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund, Sweden; Lund University, Department of Clinical Sciences, Lund, Cardiothoracic Surgery, Lund, Sweden. Electronic address: snejana.hyllen@med.lu.se.
authors.forename: Snejana
authors.initials: S
authors.lastname: Hyllén
authors.affiliation: Department of Cardiothoracic Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund, Sweden; Lund University, Department of Clinical Sciences, Lund, Cardiothoracic Surgery, Lund, Sweden.
authors.forename: Shahab
authors.initials: S
authors.lastname: Nozohoor
authors.affiliation: Department of Heart Failure and Valvular Disease, Skane University Hospital, Lund, Sweden; Lund University, Department of Clinical Sciences, Lund, Cardiology, Lund, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Ingvarsson
authors.affiliation: Department of Heart Failure and Valvular Disease, Skane University Hospital, Lund, Sweden; Lund University, Department of Clinical Sciences, Lund, Cardiology, Lund, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Meurling
authors.affiliation: Department of Cardiothoracic Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund, Sweden; Lund University, Department of Clinical Sciences, Lund, Cardiothoracic Surgery, Lund, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Wierup
authors.affiliation: Department of Cardiothoracic Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund, Sweden; Lund University, Department of Clinical Sciences, Lund, Cardiothoracic Surgery, Lund, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Sjögren
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*