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Time course of left atrial reverse remodelling after mitral valve surgery and the impact of left ventricular global longitudinal strain in patients with chronic severe mitral regurgitation

 Peter Chipeta  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Darae Kim  ;  In Jeong Cho  ;  Sak Lee  ;  Hyuck-Jae Chang  ;  Byung-Chul Chang  ;  Jong-Won Ha  ;  Namsik Chung 
 Interactive Cardiovascular and Thoracic Surgery, Vol.13(6) : 876-882, 2016 
Journal Title
 Interactive Cardiovascular and Thoracic Surgery 
Issue Date
Aged ; Atrial Remodeling/physiology* ; Cardiac Surgical Procedures ; Chronic Disease ; Echocardiography, Doppler ; Female ; Heart Ventricles/physiopathology* ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/physiopathology ; Mitral Valve Insufficiency/surgery* ; Multivariate Analysis ; Time Factors
Left atrium ; Left ventricular strain ; Mitral valve surgery ; Reverse remodelling
OBJECTIVES: We aimed to investigate the time course of left atrial (LA) reverse remodelling (LARR) after mitral valve (MV) surgery in patients with chronic severe mitral regurgitation (MR) and examine the impact of left ventricular (LV) mechanical function on LARR. METHODS: A total of 140 patients (73 males, age 54 ± 16 years) with chronic severe MR undergoing MV surgery were analysed. All patients underwent two-dimensional, Doppler and speckle-tracking echocardiography before and after surgery (1 week, 6 months and 12 months). RESULTS: There was a significant decrease in LA volume from 137.8 ± 85.5 to 89.7 ± 54.6 ml (-32.1 ± 16.7%, P < 0.001) at 1 week after surgery. LA volume further decreased to 77.4 ± 52.4 ml (-9.9 ± 13.4%, P < 0.001) at 6 months but increased to 79.7 ± 62.4 ml (3.6 ± 11.9%, P = 0.002) at 12 months after surgery. Patients with good LARR (a reduction of ≥25% in LA volume) showed lower LV global longitudinal strain (LV-GLS) than those with poor LARR (P = 0.032). In simple correlation, age (r = 0.19, P = 0.026), preoperative LA volume (r = -0.28, P = 0.001) and preoperative LV-GLS (r = 0.28, P = 0.001) showed significant correlations with the % change in LA volume, whereas no correlations were observed with preoperative LV ejection fraction, global circumferential and radial strain. In multivariate analyses, preoperative LV-GLS (β = 0.24, P = 0.014) was an independent determinant for early LARR along with age and preoperative LA volume. CONCLUSIONS: The majority of LARR after MV surgery occurred during the early postoperative period. LV-GLS, age and LA volume at surgery determined the degree of early LARR after MV surgery in patients with chronic severe MR.
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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
김다래(Kim, Da Rae)
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
이삭(Lee, Sak) ORCID logo https://orcid.org/0000-0001-6130-2342
장병철(Chang, Byung Chul)
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
정남식(Chung, Nam Sik)
조인정(Cho, In Jeong)
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
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