Joung Kyoung-Woon, Kim Seon-Ok, Nam Jae-Sik, Moon Young-Jin, Bae Hyeun-Joon, Chin Ji-Hyun, Jung Sung-Ho, Choi In-Cheol
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul 05505, Korea.
J Clin Med. 2021 Jun 26;10(13):2830. doi: 10.3390/jcm10132830.
This study sought to identify the short- and long-term changes in left ventricular ejection fraction (LVEF) after mitral valve repair (MVr) in patients with chronic primary mitral regurgitation according to preoperative LVEF (pre-LVEF) and preoperative left ventricular end-systolic diameter (pre-LVESD). This study evaluated 461 patients. Restricted cubic spline regression models were constructed to demonstrate the long-term changes in postoperative LVEF (post-LVEF). The patients were divided into four groups according to pre-LVEF (<50%, 50-60%, 60-70%, and ≥70%). The higher the pre-LVEF was, the greater was the decrease in LVEF immediately after MVr. In the same pre-LVEF range, immediate post-LVEF was lower in patients with pre-LVESD ≥ 40 mm than in those with pre-LVESD < 40 mm. The patterns of long-term changes in post-LVEF differed according to pre-LVEF ( for interaction < 0.001). The long-term post-LVEF reached a plateau of approximately 60% when the pre-LVEF was ≥50%, but it seemed to show a downward trend after reaching a peak at approximately 3-4 years after MVr when the pre-LVEF was ≥70%. The patterns of short- and long-term changes in post-LVEF differed according to pre-LVEF and pre-LVESD values in patients with chronic primary mitral regurgitation after MVr.
本研究旨在根据术前左心室射血分数（pre-LVEF）和术前左心室收缩末期内径（pre-LVESD），确定慢性原发性二尖瓣反流患者二尖瓣修复（MVr）术后左心室射血分数（LVEF）的短期和长期变化。本研究评估了461例患者。构建受限立方样条回归模型以证明术后LVEF（post-LVEF）的长期变化。根据pre-LVEF（<50%、50-60%、60-70%和≥70%）将患者分为四组。pre-LVEF越高，MVr后即刻LVEF的下降幅度越大。在相同的pre-LVEF范围内，pre-LVESD≥40 mm的患者术后即刻LVEF低于pre-LVESD<40 mm的患者。post-LVEF的长期变化模式因pre-LVEF而异（交互作用P<0.001）。当pre-LVEF≥50%时，长期post-LVEF达到约60%的平台期，但当pre-LVEF≥70%时，在MVr后约3-4年达到峰值后似乎呈下降趋势。MVr术后慢性原发性二尖瓣反流患者post-LVEF的短期和长期变化模式因pre-LVEF和pre-LVESD值而异。
