Yang Hua, Davidson William R, Chambers Charles E, Pae Walter E, Sun Benjamin, Campbell David B, Pu Min
Division of Cardiology, Division of Cardiothoracic Surgery, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0580, USA.
J Am Soc Echocardiogr. 2006 Aug;19(8):1051-5. doi: 10.1016/j.echo.2006.03.016.
Some degree of pulmonary hypertension (PHTN) is common in patients with chronic mitral regurgitation. The aim of this study was to determine whether preoperative PHTN is associated with postoperative left ventricular (LV) dysfunction.
The study included 79 patients with chronic organic mitral regurgitation. Preoperative and postoperative LV function was assessed by echocardiography. Preoperative and postoperative hemodynamics were evaluated by a pulmonary artery catheter.
Pulmonary artery systolic pressure decreased postoperatively (pre 49 +/- 14 vs. post 36 +/- 11 mm Hg, P < .01). Postoperative LV ejection fraction was significantly reduced in patients with preoperative PHTN (pre 61 +/- 11% vs post 49 +/- 12%, P < .01). A stepwise multivariate regression analysis showed that preoperative pulmonary artery systolic pressure and LV end-systolic dimension were independent predictors of postoperative LV ejection fraction (r = -0.53, P < .001, and r = -0.34, P < .05, respectively).
Preoperative PHTN is associated with postoperative LV dysfunction in patients with chronic organic mitral regurgitation undergoing mitral valve operation.
慢性二尖瓣反流患者中存在一定程度的肺动脉高压（PHTN）较为常见。本研究旨在确定术前PHTN是否与术后左心室（LV）功能障碍相关。
该研究纳入了79例慢性器质性二尖瓣反流患者。通过超声心动图评估术前和术后的左心室功能。通过肺动脉导管评估术前和术后的血流动力学。
术后肺动脉收缩压降低（术前49±14 vs. 术后36±11 mmHg，P <.01）。术前存在PHTN的患者术后左心室射血分数显著降低（术前61±11% vs. 术后49±12%，P <.01）。逐步多因素回归分析显示，术前肺动脉收缩压和左心室舒张末期内径是术后左心室射血分数的独立预测因素（分别为r = -0.53，P <.001和r = -0.34，P <.05）。
对于接受二尖瓣手术的慢性器质性二尖瓣反流患者，术前PHTN与术后左心室功能障碍相关。
