Left ventricular function in mitral valve prolapse and severe mitral regurgitation

• Published in: Rossiĭskiĭ kardiologicheskiĭ zhurnal no. 1; pp. 37 - 42
• Main Authors: Malev, E. G., Kim, G. I., Mitrofanova, L. B., Omelchenko, M. Yu, Zemtsovsky, E. V.
• Format: Journal Article
• Language: English; Russian
• Published: FIRMA «SILICEA» LLC 01.02.2013
• Subjects: barlow’s disease; fibroelastic deficiency; left ventricular function; mitral valve prolapse; severe mitral regurgitation
• ISSN: 1560-4071; 2618-7620
• DOI: 10.15829/1560-4071-2013-1-37-42

Aim. To assess systolic left ventricular (LV) function in patients with mitral valve prolapse (MVP) and different morphological MV disorders. Material and methods. The study included 233 patients (mean age 53,8±12,9 years), who underwent MV surgery due to MPV and severe mitral regurgitation (MR) at the V. A. Almazov Federal Centre of Heart, Blood, and Endocrinology in 2009-2011. The resected MV segments underwent a pathomorphological examination; preoperative strain and strain rate were assessed with the speckle tracking method (EchoPAC’08). Results. Based on the pathomorphological data, Barlow’s disease was registered in 60 patients (25,8%), and fibroelastic deficiency in 173 patients (74,2%). The preintervention echocardiography did not demonstrate any significant difference between the two groups in terms of preoperative MR volume (70,5±9,6 ml vs. 71,6±8,5 ml, p=0,40), systolic LV function (ejection fraction 52,7±6,6% vs. 52,0±7,4%; p=0,53) and diastolicLV function (E/e’ 12,2±3,9 vs. 12,8±4,2; p=0,35). Despite no difference in ejection fraction, the Barlow’s disease group demonstrated a significant reduction inLV longitudinal systolic (-13,5±2,2% vs. -16,6±2,3%; p=0,008) and diastolic strain (1,14±0,20 s-1 vs. 1,34±0,18 s-1; p=0,04), as well as in strain rate (-0.89±0,15 s-1 vs. -1,14±0,15 s-1; p=0,002), compared to the fibroelastic deficiency group. Conclusion. Patients with Barlow’s disease, compared to patients with fibroelastic deficiency, have a lower preoperative LV systolic function, which might affect the postoperative long-term survival rates. The deteriorated LV function could be due to the damage of endocardial and intramyocardial extracellular matrix in Barlow’s disease.