Journal ArticleDOI
Quantitative determinants of the outcome of asymptomatic mitral regurgitation
Maurice Enriquez-Sarano,Jean François Avierinos,David Messika-Zeitoun,Delphine Detaint,Maryann Capps,Vuyisile T. Nkomo,Christopher G. Scott,Hartzell V. Schaff,A. Jamil Tajik +8 more
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TLDR
Quantitative grading of mitral Regurgitation is a powerful predictor of the clinical outcome of asymptomatic mitral regurgitation and patients with an effective regurgitant orifice of at least 40 mm2 should promptly be considered for cardiac surgery.Abstract:
background The clinical outcome of asymptomatic mitral regurgitation is poorly defined, and the treatment is uncertain. We studied the effect on the outcome of quantifying mitral regurgitation according to recent guidelines. methods We prospectively enrolled 456 patients (mean [±SD] age, 63±14 years; 63 percent men; ejection fraction, 70±8 percent) with asymptomatic organic mitral regurgitation, quantified according to current recommendations (regurgitant volume, 66±40 ml per beat; effective regurgitant orifice, 40±27 mm 2 ). results The estimated five-year rates (±SE) of death from any cause, death from cardiac causes, and cardiac events (death from cardiac causes, heart failure, or new atrial fibrillation) with medical management were 22±3 percent, 14±3 percent, and 33±3 percent, respectively. Independent determinants of survival were increasing age, the presence of diabetes, and increasing effective regurgitant orifice (adjusted risk ratio per 10-mm 2 increment, 1.18; 95 percent confidence interval, 1.06 to 1.30; P<0.01), the predictive power of which superseded all other qualitative and quantitative measures of regurgitation. Patients with an effective regurgitant orifice of at least 40 mm 2 had a five-year survival rate that was lower than expected on the basis of U.S. Census data (58±9 percent vs. 78 percent, P=0.03). As compared with patients with a regurgitant orifice of less than 20 mm 2 , those with an orifice of at least 40 mm 2 had an increased risk of death from any cause (adjusted risk ratio, 2.90; 95 percent confidence interval, 1.33 to 6.32; P<0.01), death from cardiac causes (adjusted risk ratio, 5.21; 95 percent confidence interval, 1.98 to 14.40; P<0.01), and cardiac events (adjusted risk ratio, 5.66; 95 percent confidence interval, 3.07 to 10.56; P<0.01). Cardiac surgery was ultimately performed in 232 patients and was independently associated with improved survival (adjusted risk ratio, 0.28; 95 percent confidence interval, 0.14 to 0.55; P<0.01). conclusions Quantitative grading of mitral regurgitation is a powerful predictor of the clinical outcome of asymptomatic mitral regurgitation. Patients with an effective regurgitant orifice of at least 40 mm 2 should promptly be considered for cardiac surgery.read more
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Journal Article
Aktuelle Empfehlungen zur echokardiographischen Schweregradbeurteilung der Mitralklappeninsuffizienz : Standardisierung und praktische Anwendung mittels eines Scoringsystems
TL;DR: The present article proposes a modified practically applicable system for evaluation and scoring of severity of mitral regurgitation, and suggests that more accurate methods for direct quantification of regurgitant flow will be demanded in the future.
Dissertation
Assessment of myocardial mechanics in chronic rheumatic mitral regurgitation
TL;DR: A thesis submitted to the Faculty of Medicine, University of the Witwatersrand, for the degree of Doctor of Philosophy Johannesburg 2016.
Journal ArticleDOI
Functional mitral regurgitation in patients with heart failure and depressed ejection fraction.
TL;DR: This review provides a comprehensive summary of the pathophysiology, latest imaging modalities, and diagnostic criteria for Functional mitral regurgitation and identifies the gaps present in the knowledge of FMR to guide further clinical investigation.
Journal ArticleDOI
Mass-spring systems for simulating mitral valve repair using 3D ultrasound images.
Stephan Skornitzke,Georg Schummers,Marcus Schreckenberg,Jörg Ender,Sarah Eibel,Hans-Joachim Bungartz,Hans-Ulrich Kauczor,Wolfram Stiller +7 more
TL;DR: A mass-spring MV model based on 3D transesophageal echocardiographic (TEE) images already routinely acquired for MV repair therapy planning is presented, and it is shown that the model is able to provide a qualitative estimate of annuloplasty surgery.
Journal ArticleDOI
NT-proBNP in the mitral valve surgery.
Konstantinos Perreas,George Samanidis,Stergios Dimitriou,Athanasios Athanasiou,Marina Balanika,Anna Smirli,Christina Antzaka,Konstadinos Politis,Mazen Khoury,Alkiviadis Michalis +9 more
TL;DR: NT-proBNP is a valuable biomarker of the clinical presentation and immediate postoperative outcome in patients undergoing mitral valve surgery and can be used to predict an optimal postoperative clinical outcome.
References
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Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and doppler echocardiography
William A. Zoghbi,Maurice Enriquez-Sarano,Elyse Foster,Paul A. Grayburn,Carol D. Kraft,Robert A. Levine,Petros Nihoyannopoulos,Catherine M Otto,Miguel A. Quinones,Harry Rakowski,William J. Stewart,Alan D. Waggoner,Neil J. Weissman +12 more
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Survival after the onset of congestive heart failure in Framingham Heart Study subjects.
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