6
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      The Hemodynamic and Prognostic Significance of Echo-Doppler-Proven Mitral Regurgitation in Patients with Dilated Cardiomyopathy

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Data from cardiac catheterization at rest and during exercise in 57 patients with dilated cardiomyopathy (DCM) were analyzed to evaluate the bearing of mitral regurgiation (MR) detected by color Doppler echocardiography (CDE) on prognostically important invasive hemodynamic parameters and survival. The etiology of DCM was coronary artery disease in 21 patients and unproven (‘idiopathic’) in 36 patients. MR was detected by CDE in 34 patients (60%) with an agreement of 93% compared to left ventriculography. Mean age, etiology of DCM and duration of symptoms were similar in patients with and without MR, while patients with MR were in a higher NYHA class, had lower ejection fraction (LVEF) (25 ± 13 vs. 35 ± 17%; p < 0.02), larger left ventricular volumes (356 ± 138 vs. 268 ± 61 ml; p < 0.01) and higher left ventricular end-diastolic pressure (LVEDP) (21 ± 9 vs. 13 ± 7 mm Hg; p < 0.01). At rest, right-sided pressures were higher in patients with MR compared to patients without MR (pulmonary wedge pressure 20 ± 9 vs. 10 ± 3 mm Hg, mean pulmonary arterial pressure 30 ± 11 vs. 20 ± 8 mm Hg, mean right atrial pressure 9 ± 4 vs. 4 ± 2 mm Hg, all p < 0.001), but no significant differences were found in cardiac index (CI) or stroke index (SI). During supine bicycle exercise (increasing heart rate by 50%), both groups demonstrated a similar rise in right-sided pressures, while the patients with MR exhibited a lower increase in CI (3.5 ± 1.8 vs. 4.4 ± 1.41iters/min/m<sup>2</sup>;p < 0.05) and were unable to increase SI. When survival after 1 year was analyzed as a ‘worst-case situation’ (cardiac transplantation equals death), survival was significantly lower in patients with MR (14/34 vs. 1/23; p < 0.01). CDE is a noninvasive and accurate method for detection of MR; it is valuable for early risk stratification, being a marker of the subset of patients with DCM having reduced ventricular function and a poor prognosis.

          Related collections

          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1993
          1993
          14 November 2008
          : 83
          : 1-2
          : 14-20
          Affiliations
          Department of Cardiology B, Department of Pathology and Department of Diagnostic Radiology, Cardiovascular Section, Odense University Hospital, Odense, Denmark
          Article
          175942 Cardiology 1993;83:14–20
          10.1159/000175942
          8261482
          © 1993 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
          Categories
          General Cardiology

          Comments

          Comment on this article