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European Journal of Echocardiography Advance Access published online on September 26, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen247
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Right ventricular dilatation predicts survival after mitral valve repair in patients with impaired left ventricular systolic function

Anton Chrustowicz1,2,*,{dagger}, Gregor Simonis1,*,{dagger}, Klaus Matschke3, Ruth H. Strasser1 and Andrzej Gackowski2

1 Department of Internal Medicine, Cardiology and Intensive Care, University of Technology, Heart Centre Dresden, Fetscherstrasse 76, D-01307 Dresden, Germany
2 Department of Coronary Disease, Institute of Cardiology, Pradnicka 80, 31-202 Krakow, Poland
3 Department of Cardiac Surgery, University of Technology, Dresden, Germany

Received 24 May 2008; accepted after revision 31 August 2008.

* Corresponding author. Tel: +48 510599279; fax: +48 12 6336744. E-mail address: anton_chrustowicz{at}yahoo.de (A.C.); Tel: +49 351 450 1410; fax: +49 351 450 1702. E-mail address: gsimonis{at}gmx.de (G.S.)


  Abstract

Aims: The prognostic value of the right ventricular parameters in patients with heart failure (HF) is well documented, but the data on patients undergoing mitral valve repair are lacking.

Methods and results: The association between pre-operative right ventricular dilatation and outcome was studied in 70 consecutive patients with HF who underwent elective mitral valve repair. Mean age was 67 years, 71% were men, mean pre-operative NYHA class was 2.8, mean pre-operative ejection fraction was 31%, and 47% had atrial fibrillation. The ischaemic cardiomyopathy (ICM) was the cause of HF in 32% of the patients. Perioperative mortality was 7.1% by a median logistic Euroscore of 7.5 (range 1.3–47.5). During a mean follow-up of 887 days, 35% of the patients reached the combined endpoint of overall mortality or transplantation. Reoperation was performed in four patients. One and 3 years survival rates were 88% and 72%, respectively. By multivariate Cox analysis, right ventricular dilatation, ICM, and age significantly predicted the outcome.

Conclusion: Right ventricular dilatation is an important modulator of outcome in patients with HF and mitral regurgitation.

Keywords: Heart failure; Mitral regurgitation; Right ventricle; Mitral valve repair; Survival

{dagger} A.C. and G.S. contributed equally to this work.


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