Predictive value of preoperative left ventricular ejection fraction on left atrial reverse remodeling after mitral valve replacement

Dr. Prashant Mishra; Dr. Ganesh Kumar K. Ammannaya; Dr. Chaitanya Raut

Volume : V, Issue : X, October - 2016

Predictive value of preoperative left ventricular ejection fraction on left atrial reverse remodeling after mitral valve replacement

Dr. Prashant Mishra, Dr. Ganesh Kumar K. Ammannaya, Dr. Chaitanya Raut

Abstract :

Background: Left atrium enlargement is commonly seen in patients with mitral regurgitation (MR). Left atrium reverse remodeling (LARR) occurs after surgical correction (repair or replacement of mitral valve) of MR. Preoperative left ventricle ejection fraction (LVEF), as a predictor of this phenomenon is not well known. Methods: We retrospectively studied 200 consecutive patients who underwent mitral valve replacement (MVR) for MR in whom preoperative echocardiography report was available. The preoperative echocardiography parameters were compared. Follow up echocardiography was done during the study. LARR was defined as a reduction in left atrium volume index (LAVi)≥ 15%. Results: LARR occurred in 163 patients (81.5%), with the mean LAVi decreasing from 43.6 mL/m2 to 29.7 mL/m2 (p <0.001). These patients had a higher left ventricular ejection fraction (LVEF) (p =0.027). LVEF was identified as the preoperative predictor of LARR (odds ratio, 1.09; 95% confidence interval, 1.008–1.12). A LVEF cutoff value of 53.6% identified patients with LARR of ≥15% with a sensitivity of 86.8% and a specificity of 74.3%. Conclusion: LARR occurs frequently after mitral valve surgery and is associated with preoperative LVEF higher than 53.6%.