Abstract 3451: Prediction of Ischemic Mitral Regurgitation Recurrence after Ring Annuloplasty: A Transthoracic Echocardiography Approach
Recent studies have demonstrated that mitral regurgitation (MR) might recur after ring annuloplasty. The recurrence of MR might lead to relapse of congestive heart failure symptoms. The purpose of this study was to identify echocardiographic predictors of long-term ischemic mitral valve (MV) repair failure.
Methods. Baseline transthoracic echo examination was performed in 188 patients, 44 females (aged 59.3±13.91 years) who underwent ring annuloplasty for ischemic MR during coronary artery bypass grafting. The operations were performed using the classical technique with an undersized ring annuloplasty. MR grading was repeated 6 and 12 months and then yearly after surgery. The mean length of follow-up was 2.7±0.13 years. The impact of baseline echocardiographic measures of MR, MV and left ventricle (LV) geometry on MV repair durability in long term observation was assessed. We assesed: left ventricle end-diastolic and end-sytolic volume indices, LV ejection fraction, diastolic and systolic eccentricity indices - (L2-D2)^0.5/L (L, D - LV long, minor axis), MR jet area, MR jet area/left atrial area ratio, MV tenting area. The cut-off values of candidates for prediction of MR relapse were determined with a receiver operating characteristic (ROC) curve analysis. Univariate estimates of time-related cumulative probabilities of long-term freedom from MR equal or greater than at baseline were calculated by the Kaplan-Meier method. Multivariable adjustment was performed by Cox proportional hazards forward stepwise regression.
Results. Significant predictors of MR recurrence with cut-off values are listed in the table⇓. By Cox regression, after adjustment for age and sex, the independent predictors of late postoperative MR were baseline MR jet area, p=0.031 and systolic eccentricity index p=0.037, overall: χ2=12.592, p=0.002.
Conlusions. Simple transthoracic echocardiographic measurements might predict durability of ischemic MV repair.