Ventricular Reverse Remodeling Early after Mitral Valve Repair for Severe Chronic Mitral Regurgitation with Atrial Fibrillation

Vol. 114, No. 2, 2009

Free Abstract Article (Fulltext) Article (PDF 389 KB)

Original Research

Ventricular Reverse Remodeling Early after Mitral Valve Repair for Severe Chronic Mitral Regurgitation with Atrial Fibrillation
Bong Gun Song^a, Young Keun On^a, Eun-Seok Jeon^a, Ji Han Park^a, Jin-Oh Choi^a, Sang-Chol Lee^a, Seung Woo Park^a, June Soo Kim^a, Pyo Won Park^b

^aDivision of Cardiology, Cardiac and Vascular Center, Department of Medicine, and
^bDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address of Corresponding Author

Cardiology 2009;114:132-141 (DOI: 10.1159/000224770)

Key Words

Remodeling
Mitral regurgitation
Mitral valve repair
Atrial fibrillation
Modified maze procedure

Abstract

Objective: Chronic mitral regurgitation (MR) results in volume overload followed by left ventricular (LV) and left atrial remodeling. The aim of this study was to investigate the relation of clinical, echocardiographic findings and N-terminal B-type natriuretic peptide (NT-proBNP) to LV reverse remodeling (LVRR) early after valve repair for severe chronic MR concomitant with modified maze procedure for atrial fibrillation (AF). Methods: We retrospectively evaluated 60 patients who were surgically treated for severe chronic MR and AF. Plasma NT-proBNP and echocardiographic measurements were performed before surgery, before discharge and 12 months after surgery. Echocardiogram was additionally performed at 6 months. LVRR was assessed by looking at regression of LV mass index (LVMI) using echocardiography. Results: Fifty-two patients (87%) were classified in the LVRR group, defined as having a postoperative reduction in LVMI. The remaining patients were classified in the non-LVRR group. The non-LVRR group was older (p = 0.004), had a significantly higher ratio of patients with hypertension (p = 0.022), higher NT-proBNP levels (p = 0.007) and lower ejection fraction (p = 0.034) compared to the LVRR group. In multivariate analysis, age (odds ratio 0.874, p = 0.013) and NT-proBNP levels (odds ratio 0.185, p = 0.040) were independent predictors of LVRR. Conclusions: Preoperative lower NT-proBNP levels and younger age may predict LVRR early after surgical correction of chronic MR with AF.

Author Contacts

Young Keun On, MD
Division of Cardiology, Cardiac and Vascular Center, Department of Medicine
Samsung Medical Center, Sungkyunkwan University School of Medicine
50, Irwon-dong, Gangnam-gu, Seoul 135-710 (Korea)
Tel. +82 010 9933 3420, Fax +82 02 3410 3849, E-Mail yk.on@samsung.com

Article Information

Received: November 20, 2008
Accepted after revision: January 7, 2009
Published online: June 12, 2009
Number of Print Pages : 10
Number of Figures : 3, Number of Tables : 4, Number of References : 30

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