An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation

Rengin Cetin Guvenc; Emre Aru?aslan; Tolga Sinan Guvenc; Fatma Ozpamuk Karadeniz; Hulya Ka?ıkcıo?lu; Ne?e Cam

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저자정보: Rengin Cetin Guvenc (Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital) Emre Aru?aslan (Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital) Tolga Sinan Guvenc (Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital) Fatma Ozpamuk Karadeniz (Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital) Hulya Ka?ıkcıo?lu (Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital) Ne?e Cam (Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital)

저널정보: 한국심초음파학회 Journal of Cardiovascular Imaging Journal of Cardiovascular Imaging 제28권 제4호

발행연도: 2020.1

수록면: 267 - 278 (12page)

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BACKGROUND: It is difficult to determine left ventricular systolic performance in patients with severe mitral regurgitation (MR) since left ventricular ejection fraction (EF) could be preserved until the end stages of the disease. Myocardial efficiency (MEf) describes the amount of external work (EW) done by the left ventricle per unit of oxygen consumed (mVO2). In the present study, we aimed to investigate MEf in patients with asymptomatic severe MR using a novel echocardiographic method. METHODS: A total of 27 patients with severe asymptomatic MR and 26 healthy volunteers were included in this cross-sectional study. EW was measured using stroke volume and blood pressure, while mVO2 was estimated using double product and left ventricular mass. RESULTS: There were no differences between the groups with regards to EF (66% ± 5% vs. 69% ± 7%), while MEf was significantly reduced in patients with severe MR (25% ± 11% vs. 44% ± 12%, p < 0.001). This difference was maintained even after adjustment for age, gender and body surface area (adjusted ????? : 0.44, 95% CI: 0.39?0.49 for controls and adjusted ????? : 0.24, 95% CI: 0.19?0.29 for patients with severe MR). Further analysis showed that this reduction was due to an increase in total mVO2 in the severe MR group. MEf of thepatients who were both on β-blockers and angiotensin converting enzyme inhibitors/angiotensin receptor blockers were higher than those who were not on any drugs, but this difference was not statistically significant (32% ± 15% vs. 23% ± 9%, p = 0.41). CONCLUSIONS: MEf was significantly lower in patients with asymptomatic severe MR and preserved EF.

#Mitral regurgitation #Echocardiography #Myocardial efficiency #Left ventricular function

참고문헌 (29)

참고문헌 신청

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Enriquez-Sarano M / 2015 / Is there an outcome penalty linked to guideline-based indications for valvular surgery? Early and long-term analysis of patients with organic mitral regurgitation / J Thorac Cardiovasc Surg 150:50~58

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