Advanced

Prognostic value of pulmonary hypertension in patients undergoing surgery for degenerative mitral valve disease with leaflet prolapse.

Nozohoor, Shahab LU ; Hyllen, Snejana LU ; Meurling, Carl LU ; Wierup, Per LU and Sjögren, Johan LU (2012) In Journal of Cardiac Surgery 27(6). p.668-675
Abstract
Abstract Background and Aim of the Study: The aim of this study was to evaluate the impact of pulmonary hypertension (PH) on early and late outcomes following surgery in patients with degenerative mitral regurgitation. Methods: The study included 270 patients who had undergone isolated mitral valve surgery (MVS) for leaflet prolapse during 1998 to 2010. Pulmonary artery systolic pressure (PASP) was measured with Doppler echocardiography pre- and postoperatively. The impact of PH (PASP > 50 mmHg) on mortality and the potential for postoperative resolution of preoperatively elevated PASP was retrospectively analyzed. Results: The incidence of PH was 27% (n = 74/270). Postoperative normalization, or reduction of preoperative PASP, was... (More)
Abstract Background and Aim of the Study: The aim of this study was to evaluate the impact of pulmonary hypertension (PH) on early and late outcomes following surgery in patients with degenerative mitral regurgitation. Methods: The study included 270 patients who had undergone isolated mitral valve surgery (MVS) for leaflet prolapse during 1998 to 2010. Pulmonary artery systolic pressure (PASP) was measured with Doppler echocardiography pre- and postoperatively. The impact of PH (PASP > 50 mmHg) on mortality and the potential for postoperative resolution of preoperatively elevated PASP was retrospectively analyzed. Results: The incidence of PH was 27% (n = 74/270). Postoperative normalization, or reduction of preoperative PASP, was demonstrated in 87% of the patients with PH at a median of two months (interquartile range 1 to 19). Absent improvement or a postoperative increase in PASP was independently predicted by age (OR 1.08, 95% CI 1.02-1.14, p = 0.010). Preoperative PH resulted in a fourfold higher risk of postoperative mortality (HR 4.3, 95% CI 1.1-17.4, p = 0.039) during the first three years of follow-up. Conclusions: PH is an independent predictor of mortality during the initial three years following MVS. The majority of patients with PH demonstrated a reduction of preoperatively elevated PASP following surgery and the increased risk of mortality gradually decreased after three years. Our findings support early admission for mitral valve surgery before the occurrence of PH. (J Card Surg 2012;27:668-675). (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Cardiac Surgery
volume
27
issue
6
pages
668 - 675
publisher
Futura Publishing Company
external identifiers
  • wos:000311416000003
  • pmid:23173853
  • scopus:84870220473
ISSN
1540-8191
DOI
10.1111/jocs.12026
language
English
LU publication?
yes
id
e856b686-2927-4c1f-8345-fa2776cd5951 (old id 3218584)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23173853?dopt=Abstract
date added to LUP
2012-12-03 21:05:29
date last changed
2017-01-15 04:28:41
@article{e856b686-2927-4c1f-8345-fa2776cd5951,
  abstract     = {Abstract Background and Aim of the Study: The aim of this study was to evaluate the impact of pulmonary hypertension (PH) on early and late outcomes following surgery in patients with degenerative mitral regurgitation. Methods: The study included 270 patients who had undergone isolated mitral valve surgery (MVS) for leaflet prolapse during 1998 to 2010. Pulmonary artery systolic pressure (PASP) was measured with Doppler echocardiography pre- and postoperatively. The impact of PH (PASP > 50 mmHg) on mortality and the potential for postoperative resolution of preoperatively elevated PASP was retrospectively analyzed. Results: The incidence of PH was 27% (n = 74/270). Postoperative normalization, or reduction of preoperative PASP, was demonstrated in 87% of the patients with PH at a median of two months (interquartile range 1 to 19). Absent improvement or a postoperative increase in PASP was independently predicted by age (OR 1.08, 95% CI 1.02-1.14, p = 0.010). Preoperative PH resulted in a fourfold higher risk of postoperative mortality (HR 4.3, 95% CI 1.1-17.4, p = 0.039) during the first three years of follow-up. Conclusions: PH is an independent predictor of mortality during the initial three years following MVS. The majority of patients with PH demonstrated a reduction of preoperatively elevated PASP following surgery and the increased risk of mortality gradually decreased after three years. Our findings support early admission for mitral valve surgery before the occurrence of PH. (J Card Surg 2012;27:668-675).},
  author       = {Nozohoor, Shahab and Hyllen, Snejana and Meurling, Carl and Wierup, Per and Sjögren, Johan},
  issn         = {1540-8191},
  language     = {eng},
  number       = {6},
  pages        = {668--675},
  publisher    = {Futura Publishing Company},
  series       = {Journal of Cardiac Surgery},
  title        = {Prognostic value of pulmonary hypertension in patients undergoing surgery for degenerative mitral valve disease with leaflet prolapse.},
  url          = {http://dx.doi.org/10.1111/jocs.12026},
  volume       = {27},
  year         = {2012},
}