Background: Chronic severe pulmonary regurgitation (PR) causes progressive right ventricular (RV) dysfunction and heart failure. Parameters defining the optimal time point for surgery of chronic PR are lacking. The present study prospectively evaluated the impact of preoperative clinical parameters, cardiorespiratory function, QRS duration and NT-proBNP levels on post operative RV function and volumes assessed by cardiac magnetic resonance imaging (CMR) in patients with chronic severe PR undergoing pulmonary valve replacement.
Methods And Results: CMR was performed pre- and 6 months postoperatively in 27 patients (23.6 ± 2.9 years, 15 women) with severe PR. Postoperatively, RV endsystolic (RVESVI) and enddiastolic volume indices (RVEDVI) decreased significantly (RVESVI pre 78.2 ± 20.4 ml/m² BSA vs. RVESVI post 52.2 ± 16.8 ml/m²BSA, p<0.001; RVEDVI pre 150.7 ± 27.7 ml/m²BSA vs. RVEDVI post 105.7 ± 26.7 ml/m²BSA; p<0,001). With increasing preoperative QRS-duration, postoperative RVEF decreased significantly (r=-0.57; p<0.005). Preoperative QRS-duration smaller than the median (156 ms) predicted an improved RVEF compared to QRS-duration≥ 156 ms (54.9% vs 46.8%, p<0.05). Multivariate analysis identified preoperative QRS duration as an independent predictor of postoperative RVEF (p<0.005). NT-proBNP levels correlated with changes in RVEDI (r=0.58 p<0,005) and RVESVI (r=0.63; p<0,0001). Multivariate analysis identified NT-proBNP levels prior to PVR as an independent predictor of volume changes (p<0.05).
Conclusion: Valve replacement in severe pulmonary regurgitation causes significant reduction of RV volumes. Both, preoperative NT-proBNP level elevation and QRS prolongation indicate patients with poorer outcome regarding RV function and volumes.
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http://dx.doi.org/10.1016/j.ijcard.2010.05.064 | DOI Listing |
World J Cardiol
December 2024
Department of Radiology, Christus Muguerza Hospital Betania, Puebla 72501, Mexico.
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View Article and Find Full Text PDFJ Cardiovasc Dev Dis
December 2024
Faculty of Medicine & Health Sciences, University of Antwerp, 2610 Antwerp, Belgium.
The need for a permanent pacemaker (PPM) implantation after surgical aortic valve implantation (SAVR) is a recognized postoperative complication, with potentially long-term reduced survival. From 1987 to 2017, 2500 consecutive patients underwent SAVR with a biological valve with or without concomitant procedures such as CABG or mitral valve repair. Mechanical valves or valves in another position were excluded.
View Article and Find Full Text PDFJ Pers Med
December 2024
Department of Prosthodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
The aim of this study was to determine whether the oral parameter reflecting the total number of remaining permanent teeth (NRT) on both arches represents a predictability factor for a certain type of cardiovascular condition. : This study included 84 subjects (40 males and 44 females) with ages between 50 and 89 years old, hospitalized in the Cardiology Department, who required dental examinations and specialized therapeutic interventions within the Emergency Dental Department of the same medical facility. : The study participant's data were statically analyzed.
View Article and Find Full Text PDFJ Pers Med
November 2024
Department of Pulmonary and Critical Care Medicine, The University of Toledo, Toledo, OH 43606, USA.
Aortic stenosis (AS) is a critical valvular heart disease associated with significant morbidity and mortality if not managed promptly. Previous studies have highlighted the "weekend effect", where the day of admission impacts outcomes in various cardiac conditions. This study evaluates the impact of weekend versus weekday admissions on outcomes in patients admitted with acutely decompensated aortic stenosis.
View Article and Find Full Text PDFDiseases
December 2024
Department of Neurology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Noncardiogenic pulmonary edema after cardiac surgery is a rare but severe complication. The etiology remains poorly understood; however, the issue may arise from multiple sources. Possible causes include a significant inflammatory response or an autoimmune process.
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