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Factors determining early left atrial reverse remodeling after mitral valve surgery

Authors
 Deok-Kyu Cho  ;  Jong-Won Ha  ;  Byung-Chul Chang  ;  Se-Hwa Lee  ;  Se-Jung Yoon  ;  Chi Young Shim  ;  Jung Rae Cho  ;  Jung-Sun Kim  ;  Eui-Young Choi  ;  Se-Joong Rim  ;  Namsik Chung 
Citation
 AMERICAN JOURNAL OF CARDIOLOGY, Vol.101(3) : 374-377, 2008 
Journal Title
 AMERICAN JOURNAL OF CARDIOLOGY 
ISSN
 0002-9149 
Issue Date
2008
MeSH
Adult ; Age Factors ; Cardiac Volume ; Dilatation, Pathologic ; Female ; Heart Atria/pathology* ; Heart Atria/physiopathology ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency/surgery* ; Mitral Valve Stenosis/surgery* ; Multivariate Analysis ; Postoperative Period
Keywords
Adult ; Age Factors ; Cardiac Volume ; Dilatation, Pathologic ; Female ; Heart Atria/pathology* ; Heart Atria/physiopathology ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency/surgery* ; Mitral Valve Stenosis/surgery* ; Multivariate Analysis ; Postoperative Period
Abstract
This study aimed to investigate the factors determining early left atrial (LA) reverse remodeling after mitral valve (MV) surgery. The left atrium is frequently dilated in patients with mitral stenosis (MS) or mitral regurgitation (MR). MV surgery usually results in LA volume reduction. However, the factors associated with LA reverse remodeling after MV surgery are not clearly defined. One hundred thirty-eight patients (51 men, 87 women; mean age, 53 years) underwent transthoracic echocardiography before and after MV surgery. Maximal LA volume was measured using the prolate ellipsoid model. The percentage of LA volume change was calculated. The patients were grouped according to age (<50 vs >or=50 years), predominant lesion (pure MR vs some degree of MS), type of surgery (MV repair vs MV replacement), and preoperative rhythm (sinus rhythm vs atrial fibrillation). LA volume decreased from 147+/-93 to 103+/-43 ml (p<0.001) after surgery. LA reverse remodeling was more prominent in patients who were <50 years old (percentage of LA volume change -31.2+/-17.4 vs -18.4+/-19.2, p<0.001), had pure MR (percentage of LA volume change -30.4+/-18.6 vs -17.3+/-18.2, p<0.001), and had a preoperative sinus rhythm (percentage of LA volume change -28.5+/-17.7 vs -20.5+/-20.0, p=0.019). In conclusion, on stepwise multiple regression analysis, preoperative LA volume, predominant lesion, age, and cardiac rhythm were significant predictors of LA reverse remodeling. A larger preoperative LA volume, MR rather than MS, younger age at the time of surgery, and sinus rhythm were important predictors of LA reverse remodeling after MV surgery.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002914907019248
DOI
10.1016/j.amjcard.2007.09.076
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Yoon, Se Jung(윤세정)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Chang, Byung Chul(장병철)
Chung, Nam Sik(정남식)
Cho, Deok Kyu(조덕규)
Cho, Jung Rae(조정래)
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106850
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