Sadeghian Hakimeh, Oloomi Babak, Ahmadi Tafti Seyed Hossein, Shafiee Akbar, Jalali Arash, Masoumi Mohammad Amin
Department of Cardiology, Dr. Shariati Hospital, Tehran University of Medical Science, Tehran, Iran.
Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Science, Tehran, Iran.
J Cardiovasc Thorac Res. 2025 Jun 28;17(2):133-138. doi: 10.34172/jcvtr.025.33277. eCollection 2025 Jun.
The natural course and clinical significance of moderate mitral regurgitation (MR) in patients undergoing isolated coronary artery bypass graft (CABG) surgery are still debated. This study aimed to determine the course of moderate functional MR after CABG.
In this registry-based cohort, patients who underwent isolated elective CABG at Tehran Heart Center between 2010 and 2017 were included. Transthoracic echocardiography was performed at baseline before CABG and after 12 months of follow-up. The outcomes of interest were both improvement and progression of MR during the study.
Among 291 patients with moderate functional MR, the mean age was 66.1±9.6 years, and 204 (70.1%) were males. Most of the study population had extensive coronary disease (240 patients; 82.5% with thee-vessel disease). Moreover, 101 patients (34.7%) had suffered a prior myocardial infarction. The mean LVEF before CABG was 42.0±9.9 and 145 patients (49.8%) had an LVEF≤40% prior to surgery.The median follow-up duration was 10.1 months (9.0-11.2). Only four patients had improvements in MR at follow-up. Eleven patients (3.8%) in the study population showed worsening MR after isolated CABG. In this group of patients, mean LVEF dropped from 44.1±10.9 at baseline to 41.8±11.5 during follow-up Due to the low number of cases with regression and progression, an analysis of predictors of MR change was not performed.
This study showed that in patients with moderate functional MR, isolated CABG did not result in significant changes in the degree of MR.
接受单纯冠状动脉旁路移植术（CABG）的患者中，中度二尖瓣反流（MR）的自然病程及临床意义仍存在争议。本研究旨在确定CABG术后中度功能性MR的病程。
在这个基于注册登记的队列研究中，纳入了2010年至2017年期间在德黑兰心脏中心接受单纯择期CABG的患者。在CABG术前基线及随访12个月后进行经胸超声心动图检查。研究关注的结局是研究期间MR的改善和进展情况。
在291例中度功能性MR患者中，平均年龄为66.1±9.6岁，男性204例（70.1%）。大多数研究人群患有广泛的冠状动脉疾病（240例患者；82.5%为三支血管病变）。此外，101例患者（34.7%）曾发生过心肌梗死。CABG术前的平均左心室射血分数（LVEF）为42.0±9.9，145例患者（49.8%）术前LVEF≤40%。中位随访时间为10.1个月（9.0 - 11.2）。随访时只有4例患者的MR有所改善。研究人群中有11例患者（3.8%）在单纯CABG术后MR恶化。在这组患者中，平均LVEF从基线时的44.1±10.9降至随访期间的41.8±11.5。由于MR消退和进展的病例数较少，未对MR变化的预测因素进行分析。
本研究表明，对于中度功能性MR患者，单纯CABG术后MR程度无显著变化。
