缺血性二尖瓣反流瓣环成形术后晚期复发性二尖瓣反流
Recurrent mitral regurgitation late after annuloplasty for ischemic mitral regurgitation.
作者信息
Shiota Maiko, Gillinov A Marc, Takasaki Kunitsugu, Fukuda Shota, Shiota Takahiro
机构信息
Department of Cardiovascular Medicine Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic, Cleveland, Ohio, USA.
出版信息
Echocardiography. 2011 Feb;28(2):161-6. doi: 10.1111/j.1540-8175.2010.01284.x.
In 106 patients who had mitral annuloplasty for ischemic mitral regurgitation (MR), 71 patients (67%) had satisfactory outcomes with <2+ MR (grade 0-4) throughout the follow-up period (44 ± 31 months), while 35 patients (33%) had significant recurrent MR (≥2+) late after annuloplasty (≥6 months) during the follow-up period (45 ± 30 months). Compared to those with recurrent MR, the success group had a significantly higher proportion of patients whose left ventricular (LV) ejection fraction (EF) stayed stable or increased over the follow-up period postoperatively (47/70 = 67% vs. 14/35 = 40%, P < 0.01). The success group had a higher proportion of patients whose LV end-systolic volume stayed stable or decreased (37/63 = 59% vs. 6/35 = 17%, P < 0.01) and lower LV sphericity in systole (0.46 ± 0.096 vs. 0.60 ± 0.10, P < 0.01). In conclusion, recurrent ischemic MR after annuloplasty is associated with increasing LV size, decreasing LVEF, and increasing sphericity of the LV.
在106例行缺血性二尖瓣反流（MR）二尖瓣环成形术的患者中，71例（67%）在整个随访期（44±31个月）内获得了满意的结果，二尖瓣反流程度<2+（0-4级），而35例（33%）在随访期（45±30个月）内二尖瓣环成形术后晚期（≥6个月）出现了严重的复发性二尖瓣反流（≥2+）。与复发性二尖瓣反流患者相比，成功组中左心室（LV）射血分数（EF）在术后随访期保持稳定或增加的患者比例显著更高（47/70 = 67%对14/35 = 40%，P<0.01）。成功组中左心室收缩末期容积保持稳定或减小的患者比例更高（37/63 = 59%对6/35 = 17%，P<0.01），且收缩期左心室球形度更低（0.46±0.096对0.60±0.10，P<0.01）。总之，二尖瓣环成形术后复发性缺血性二尖瓣反流与左心室大小增加、左心室射血分数降低以及左心室球形度增加有关。
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