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  • Incremental value of three-dimensional echocardiography in the evaluation of left ventricular size in mitral regurgitation: A follow-up study after mitral valve surgery

    Author(s)
    Yingchoncharoen, T
    Negishi, T
    Stanton, T
    Marwick, TH
    Griffith University Author(s)
    Stanton, Tony
    Year published
    2014
    Metadata
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    Abstract
    Background Increased left ventricular (LV) dimensions are an indication for surgery in patients with asymptomatic mitral regurgitation, but M-mode or two-dimensional measurements have known limitations. The aim of this study was to determine the value of three-dimensional echocardiography in predicting postoperative outcomes after mitral surgery. Methods Sixty-seven patients with severe asymptomatic or minimally symptomatic mitral regurgitation (69% men; mean age, 62 ± 13 years) who underwent mitral valve surgery from January 2010 to December 2011 were studied. In addition to standard echocardiography, baseline three-dimensional ...
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    Background Increased left ventricular (LV) dimensions are an indication for surgery in patients with asymptomatic mitral regurgitation, but M-mode or two-dimensional measurements have known limitations. The aim of this study was to determine the value of three-dimensional echocardiography in predicting postoperative outcomes after mitral surgery. Methods Sixty-seven patients with severe asymptomatic or minimally symptomatic mitral regurgitation (69% men; mean age, 62 ± 13 years) who underwent mitral valve surgery from January 2010 to December 2011 were studied. In addition to standard echocardiography, baseline three-dimensional echocardiography was performed for accurate quantification of LV size. Patients were followed over a median time of 1 month (interquartile range, 0-8 months) for postoperative development of atrial fibrillation or LV dysfunction. A multivariate regression analysis was performed to identify associations with events. Results Postoperative LV dysfunction developed in 15 patients (22%), and 21 patients (31%) had postoperative atrial fibrillation. There was no association between two-dimensional end-systolic volume index and outcomes (hazard ratio, 1.02; P =.18). Postoperative atrial fibrillation or LV dysfunction was associated with baseline three-dimensional LV end-systolic volume index (hazard ratio, 1.06; 95% confidence interval, 1.04-1.16), independent of age and presence of coronary artery disease. LVESVi ≥ 40 mL/m2 was the best cutoff value to predict postoperative events (sensitivity, 80%; specificity, 85%). After adding LVESVi to a model containing clinical and echocardiographic parameters, net reclassification improvement was 0.27 (95% confidence interval, 0.25-0.29; P =.024). Conclusions LVESVi from three-dimensional echocardiography is an independent predictor of postoperative outcomes in patients with severe mitral regurgitation that is incremental to other clinical and echocardiographic variables. © 2014 by the American Society of Echocardiography.
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    Journal Title
    Journal of the American Society of Echocardiography
    Volume
    27
    Issue
    6
    DOI
    https://doi.org/10.1016/j.echo.2014.02.009
    Subject
    Cardiovascular medicine and haematology
    LV dimensions
    LV volume
    Mitral regurgitation
    Three-dimensional echocardiography
    Two-dimensional echocardiography
    Publication URI
    http://hdl.handle.net/10072/411741
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    • Journal articles

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