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首页> 外文期刊>The journal of Tehran Heart Center. >Left Ventricular Dimension after Mitral Valve Surgery in Rheumatic Mitral Stenosis: the Impact of Myocardial Fibrosis
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Left Ventricular Dimension after Mitral Valve Surgery in Rheumatic Mitral Stenosis: the Impact of Myocardial Fibrosis

机译：二尖瓣手术后左心室尺寸在风湿二尖瓣狭窄：心肌纤维化的影响

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Background: Patients with rheumatic mitral stenosis (MS) experience changes in left ventricular (LV) dimensions after mitral valve surgery. We sought to investigate changes in LV dimensional parameters after mitral valve surgery and find out whether the same changes occurred in different extents of myocardial fibrosis.Methods: This prospective observational study comprised 43 patients with rheumatic MS planned for mitral valve surgery between October 2017 and April 2018 in National Cardiovascular Center Harapan Kita (NCCHK) Jakarta. All the patients underwent cardiac magnetic resonance imaging based on the late gadolinium enhancement (LGE) protocol for myocardial fibrosis assessment prior to surgery. The patients were classified according to the estimated fibrosis volume considered to influence hemodynamic performance (myocardial fibrosis 5% and myocardial fibrosis ≥5%). Serial transthoracic echocardiographic examinations before and after surgery were performed to detect changes in LV dimensional parameters.Results: This study consisted of 31 (72.1%) women and 12 (27.9%) men at a mean age of 46±9 years. The LGE protocol revealed myocardial fibrosis of less than 5% in 32 (74.4%) patients. A significant increase was detected in the LV end-diastolic diameter postoperatively, specifically in the patients with myocardial fibrosis of less than 5% (44.0±4.8 mm vs 46.6±5.6 mm; P value=0.027). A similar significant increase was not found in the other group (45.0±6.6 mm vs 46.7±6.9 mm; P value=0.256). Other changes in echocardiographic parameters showed similar patterns in both groups.Conclusion: Our patients with rheumatic MS who had myocardial fibrosis of less than 5% demonstrated better improvements in terms of increased preload. Myocardial fibrosis of less than 5% is associated with more favorable improvements in LV geometry.
机译：背景：患有风湿性二尖瓣狭窄（MS）的患者在二尖瓣手术后左心室（LV）尺寸的变化。我们试图研究二尖瓣手术后LV尺寸参数的变化，并找出在心肌纤维化的不同范围内发生同样的变化。方法：这项前瞻性观察研究组织了43例患有2017年10月和4月的二尖瓣手术的风湿MS患者2018年在全国心血管中心Harapan Kita（Ncchk）雅加达。所有患者均基于前期钆增强（LGE）方案进行心肌纤维化评估前的心肌共振成像。根据认为影响血液动力学性能的估计纤维化体积（心肌纤维化<5％和心肌纤维化≥5％），患者分类。进行手术前后的序列性超声心动图检查，以检测LV尺寸参数的变化。结果：本研究由31名（72.1％）和12名（27.9％）男性组成，平均年龄为46±9年。 LGE协议显示32例（74.4％）患者的心肌纤维化小于5％。在术后LV端舒张直径中检测到显着增加，特别是在心肌纤维化患者小于5％（44.0±4.8mm Vs 46.6±5.6 mm; P值= 0.027）。在另一组中未发现类似的显着增加（45.0±6.6mm Vs 46.7±6.9 mm; p值= 0.256）。超声心动图参数的其他变化显示了两种群体的类似模式。结论：我们具有小于5％的心肌纤维化的风湿MS的患者表现出更好的预加载方面的改进。小于5％的心肌纤维化与LV几何形状的更有利改善有关。

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