Preoperative Pulmonary Hypertension Is Associated with Postoperative Left Ventricular Dysfunction in Chronic Organic Mitral Regurgitation: An Echocardiographic and Hemodynamic Study

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Abstract

Background

Some degree of pulmonary hypertension (PHTN) is common in patients with chronic mitral regurgitation. The aim of this study was to determine whether preoperative PHTN is associated with postoperative left ventricular (LV) dysfunction.

Methods

The study included 79 patients with chronic organic mitral regurgitation. Preoperative and postoperative LV function was assessed by echocardiography. Preoperative and postoperative hemodynamics were evaluated by a pulmonary artery catheter.

Results

Pulmonary artery systolic pressure decreased postoperatively (pre 49 ± 14 vs. post 36 ± 11 mm Hg, P < .01). Postoperative LV ejection fraction was significantly reduced in patients with preoperative PHTN (pre 61 ± 11% vs post 49 ± 12%, P < .01). A stepwise multivariate regression analysis showed that preoperative pulmonary artery systolic pressure and LV end-systolic dimension were independent predictors of postoperative LV ejection fraction (r = −0.53, P < .001, and r = −0.34, P < .05, respectively).

Conclusion

Preoperative PHTN is associated with postoperative LV dysfunction in patients with chronic organic mitral regurgitation undergoing mitral valve operation.

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