Abstract 20149: Effect of Mitral Valve Area Following Surgical Repair for Degenerative Mitral Regurgitation on Exercise Hemodynamics and Functional Consequences
Introduction: Mitral valve (MV) area is the key measure of mitral stenosis (MS) in rheumatic MV disease, but its role in the follow-up of patients who had MV repair for degenerative mitral regurgitation (MR) remains uncertain. Our objective is to evaluate the relationships of MV area with hemodynamic effects at rest and during exercise, and with functional measures in patients following MV repair for degenerative MR.
Methods: We prospectively assessed 110 patients who had MV repair for degenerative MR and no more than mild residual MR. Patients with aortic valve disease and ventricular dysfunction were excluded. The patients underwent comprehensive echo assessment at rest and during supine bicycle exercise. Brain natriuretic peptide (BNP) levels and SF36 questionnaires were also performed. MV area was calculated using the continuity equation. The patients were divided into 2 groups for comparison (MV area < 1.5 cm2 vs > 1.5 cm2).
Results: 22 patients (20%) had MV area < 1.5 cm2. The 2 groups were similar in age. Patients with MVR < 1.5 cm2 had worse resting and exercise hemodynamics, more limited exercise capacity and higher BNP levels compared to those with larger MV area (Table). These patients also had lower scores in physical functioning, vitality (p=0.01) and social function (p=0.04), based on the SF36 questionnaires. Multivariate analysis showed that MV area is an independent predictor of exercise capacity (p=0.003).
Conclusion: In patients following MV repair for degenerative MR, MV area is a useful measure of MS severity because it is associated with resting and exercise hemodynamics and functional consequences. MV area should be routinely measured in this clinical setting, and refinement in MV repair techniques is needed to optimize MV area in addition to eliminate MR.
Author Disclosures: K. Chan: None. T. Mesana: None. B. Lam: None.
- © 2014 by American Heart Association, Inc.