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Predictive value of echocardiographic indices in chronic mitral regurgitation (a ten-year retrospective study).


Na. Lourdes S. Casas

Related Institution

Division of Pediatric Cardiology - Philippine Heart Center

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Cardiology
Publication Date
January-March 1996


Post-operative left ventricular dusfunction (LVD) is the most common cause of mortality in patients after mitral valve (MV) surgery due to mitral regurgitation (MR). The aims of this study were to determine two-dimensional echocardiography (2-D Echo) parameters that might predict the left ventricular response after MV surgery and eventually to note the timing of surgery for optimum results.

Of the 44 patients who underwent MV surgery for pure MR of rheumatic etiology at the Philippine Heart Center between to 1983 to 1994, only 40 charts were available for review. The mean age were between 15± 3 y/o with 21 females and 19 males. Echocardiogram done 1 week pre-operatively and 1 to 3 months postoperatively were reviewed for the following parameters: left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left atrial (LA) size and ejection fraction )EF).Measurements of LVEDD, LVESD and LA were based on Zile's recommendation using body surface area. Of the 40 patients reviewed, 15 died within the first 3 months after surgery. There were 7 patients with LVEDD less than 4 cm/m² and 6 improved while 1 expired due to infective endocarditis. Of the 33 whose LVEDD was more than 2 cm/m², 19 did not improve which included 14 mortalities and this was significant (p<0.05). There were 5 patients who had LVESD less than 2.6 cm/m². Sixteen did not improve with 13 mortalities which was not significant (p>0.05). Ejection fraction less than 50% were noted in 10 patients, all of whom expired while in 30 with EF more than 50%, 15 did not improve with 5 mortalities which was significant (p<0.01). Thirty eight patients had an LA size of >24 cm and 18 did not improve including 15 mortalities. We conclude that LVEDD less than 4 cm/m² and EF more than 50% were good predictors of improvement after MV surgery for patients with pure MR rheumatic in origin.


1. Boucher, C.A. , et al, . "Early changes in left ventricular volume overload" American Journal of Cardiology 47, 991-1004, 1981
2. Shuler, G. , et al, . "Temporal response of left ventricular performance of mitral valve surgery" Circulation 59, 1218-1231, 1979
3. Zile, M.R. , et al, . "Chronic mitral regurgitation: Predictive value of preoperative Echocardiographic Indices of Left ventricular function and wall stress" Journal of the American College of Cardiology 3, 235-242, 1984
4. Weisenbaugh, T. , et al, . "Prediction of outcome after valve replacement for rheumatic mitral regurgitation in the era of chordal preservation" Circulation , 191-197, January 1989
5. Borow, K. , et al, . "End systolic volume as predictor of postoperative left ventricular performance in Volume Overload form Valvular regurgitation" The American Journal of Medicine 68, 655-663, 1980
6. Crawford, M. , et al, . "Determinants of survival and left ventricular performance after mitral valve replacement" Circulation 81, 1173-1181, 1990
7. Phillips, H.R. , et al, . "Mitral replacement for isolated mitral regurgitation: Analysis of clinical course and late post-operative left ventricular ejection fraction" American journal of Cardiology 48, 647-654, 1981
8. Reed, D. , et al, . "Prediction of outcome after mitral valve replacement in patients with symptomatic chronic regurgitation: Importance of left atrial size" Circulation 84, 23-24, 1991
9. Grossman, W. , et al, . "Contractile state of the left ventricle in man as evaluated from end systolic pressure-volume relations" Circulation 56, 845-850, 1977
10. Eckberg, D.L. , et al, . "Mechanisms of left ventricular contraction in chronic severe mitral regurgitation" Circulation 47, 1252, 1973

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