Although the occurrences of primary failure of valve repair 9 or replacement 10 11 and of left ventricular dysfunction 12 have been recognized, their respective roles in postoperative congestive heart failure are unclear. In addition to the uncertainty about the frequency of this complication, the mechanisms of heart failure have not been fully analyzed.
2 3 4 5 6 However, the long-term outcome after surgical correction of mitral regurgitation is less well known 7 8 in particular, the incidence and impact of congestive heart failure on late survival after valve repair or replacement remain poorly defined. 1 Indeed, intermediate-term studies have demonstrated marked improvement in symptoms after surgical correction. In patients with mitral regurgitation, surgical intervention is intended to treat and to prevent the occurrence of congestive heart failure. These data should lead to earlier indication of surgical correction of mitral regurgitation, before left ventricular dysfunction occurs. This complication is due most often to left ventricular dysfunction its main determinant is decreased left ventricular function preoperatively. The performance of valve repair was independently predictive of a lower incidence of the combined end point of death and heart failure ( P=.001), compared with valve replacement.Ĭonclusions Congestive heart failure frequently occurs late after surgical correction of mitral regurgitation and portends dismal prognosis. With multivariate analysis, the independent predictors of postoperative heart failure were preoperative ejection fraction ( P=.0001), coronary artery disease ( P=.0017), and New York Heart Association functional class ( P=.012), with borderline value for atrial fibrillation ( P=.10). Cause of congestive heart failure was left ventricular dysfunction in two thirds of the patients and valvular dysfunction in the other third. Survival after the first episode of congestive heart failure was dismal, 44±4% at 5 years. Cumulative incidence of congestive heart failure was 23☒%, 33☓%, and 37☓% at 5, 10, and 14 years, respectively. Survival was 77☒% and 56☓% at 5 and 10 years, respectively. Methods and Results The long-term outcome of 576 operative survivors of surgical correction of pure mitral regurgitation performed between 19 was analyzed. Customer Service and Ordering Informationīackground In patients with mitral regurgitation, surgical intervention produces immediate improvement in symptoms, but the long-term incidence and significance of postoperative congestive heart failure are unknown.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).Pathophysiology and treatment of atherosclerosis : Current view and future perspective on lipoprotein modification treatment. Cigarette Smoking Linked Heart Attacks In Early 50's For People With Common Gene Variant. Cholesteryl ester transfer protein polymorphism (TaqIB) associates with risk in postinfarction patients with high C-reactive protein and high-density lipoprotein cholesterol levels. 2019.Ĭorsetti JP, Ryan D, Rainwater DL, Moss AJ, Zareba W, Sparks CE. The Role of Lipids and Lipoproteins in Atherosclerosis. Acrolein: sources, metabolism, and biomolecular interactions relevant to human health and disease. Acrolein impairs the cholesterol transport functions of high density lipoproteins. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. High-density lipoprotein (HDL) functionality and its relevance to atherosclerotic cardiovascular disease. A consensus statement from the European Atherosclerosis Society Consensus Panel. Evidence from genetic, epidemiologic, and clinical studies. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 2019.įerence BA, Ginsberg HN, Graham I, et al. Acrolein Can Cause Cardiovascular Disease: A Review. Henning RJ, Johnson GT, Coyle JP, Harbison RD. Molecular mechanisms of acrolein toxicity: relevance to human disease.
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