Ad Astra Awards
Ad Astra Journal
Science library
White book
University rankings
Who's who
Theses and dissertations
Ad Astra association
Press releases
Funding opportunities
>> Românã

Antonini-Canterin F, Beladan CC, Popescu BA, Ginghina C, Popescu AC, Piazza R, Leiballi E, Zingone B, Nicolosi GL. Left atrial remodelling early after mitral valve repair for degenerative mitral regurgitation. Heart, 94, pp. 759-764, 2008.

Abstract: Objective: Left atrial (LA) size is an important predictor of outcome after mitral valve replacement in patients with symptomatic chronic mitral regurgitation (MR). Data on LA remodelling after mitral valve repair (MVr) for chronic non-ischaemic MR are scarce. The aim of this study was to assess changes in LA size early after MVr for chronic severe degenerative MR and to identify clinical and echocardiographic correlates of those changes.
Methods: The study analysed 225 consecutive patients who underwent MVr and were echocardiographically evaluated in our hospital within 1 month before and 16 months after surgery. Patients with MR aetiology other than degenerative, associated aortic valve replacement, or congenital heart disease were excluded. The remaining 79 patients (aged 60 (SD 12) years, 55 men) with
isolated chronic severe degenerative MR formed the study group. LA reverse remodelling was defined as a decrease in LA volume index (LAVi) >15%.
Results: LA dimensions significantly decreased after MVr (p<0.001). Mean LAVi reduction was 29% (SD 18%). LA reverse remodelling was observed in 63 patients (80%). Correlates of LAVi reduction were preoperative LAVi (p=0.008), systolic and diastolic blood pressure(p=0.032, p=0.009), postoperative transmitral mean
pressure gradient (p=0.001) and residual MR (p=0.043). LAVi reduction was lower in patients >45 years (p=0.008) and in hypertensive patients (p=0.031).
Conclusion: LA reverse remodelling is common early after MVr for chronic severe degenerative MR.
Preoperative LAVi, blood pressure, postoperative transmitral mean pressure gradient, residual MR and age >45 are related to LAVi reduction. The prognostic value of LA reduction in this setting needs further study.

Keywords: cardiac remodelling, left atrium, mitral regurgitation, mitral valve repair


Posted by Bogdan Alexandru Popescu


© Ad Astra 2001-2013