Relation of aneurysmectomy in patients with advanced left ventricular remodeling to postoperative left ventricular filling pressure, redilatation with ischemic mitral regurgitation.
Relation of aneurysmectomy in patients with advanced left ventricular remodeling to postoperative left ventricular filling pressure, redilatation with ischemic mitral regurgitation.
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DOI：
10.1016/j.amjcard.2004.10.024
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发表时间：
2005-02
期刊：
影响因子：
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通讯作者：
Y. Otsuji;Eiji Kuwahara;K. Yuge;G. Yotsumoto;T. Ueno;Kenichi Nakashiki;S. Hamasaki;S. Biro;
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文献类型：
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作者：
Y. Otsuji;Eiji Kuwahara;K. Yuge;G. Yotsumoto;T. Ueno;Kenichi Nakashiki;S. Hamasaki;S. Biro;
应用超声心动图测量14例左室肥厚手术患者的左室容积、二尖瓣E减速时间和二尖瓣返流分数。14例患者中有5例（36%）在术后3 - 6个月发生晚期二尖瓣返流。与无晚期二尖瓣返流的患者相比，晚期二尖瓣返流患者的术前左室舒张末期容积指数（LVEDVI）显著增大（134 ± 21 vs 93 ± 19 ml/m2，p <0.01），手术减少LVEDVI（−51 ± 14 vs −20 ± 16 ml/m2，p <0.01），术后早期LV舒张功能障碍伴二尖瓣E减速时间缩短（106 ± 23 vs 141 ± 24 ms，p <0.01），术后晚期LVEDVI再增加（+28 ± 4 vs +3 ± 8 ml/m2，p <0.01），表明术前LV重塑晚期患者的手术LV扩张术可能导致术后LV舒张功能障碍，促进后期LV再扩张伴缺血性MR。
Left ventricular (LV) volume, mitral E deceleration time, and mitral regurgitation (MR) fraction were measured by echocardiography in 14 patients with surgical LV aneurysmectomy. Late MR developed 3 to 6 months after surgery in 5 of the 14 patients (36%). Compared with patients without late MR, those with late MR had a significantly greater preoperative LV end-diastolic volume index (LVEDVI) (134 ± 21 vs 93 ± 19 ml/m2, p <0.01), surgical reduction in LVEDVI (−51 ± 14 vs −20 ± 16 ml/m2, p <0.01), early postoperative LV diastolic dysfunction with shortened mitral E deceleration time (106 ± 23 vs 141 ± 24 ms, p <0.01), and a late postoperative reincrease in LVEDVI (+28 ± 4 vs +3 ± 8 ml/m2, p <0.01), suggesting that surgical LV aneurysmectomy in patients with advanced preoperative LV remodeling may result in postoperative LV diastolic dysfunction, promoting later LV redilation with ischemic MR.