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Perioperative changes of the slope in the preload recruitable stroke work relationship by a single-beat technique after mitral valve surgery in functional mitral regurgitation with non-ischemic dilated cardiomyopathy.
Gen Thorac Cardiovasc Surg 2020; 68(1):30-37GT

Abstract

OBJECTIVES

The slope in the preload recruitable stroke work relationship is a highly linear, load-insensitive contractile parameter. However, the perioperative change of the slope has not been reported before. We examined the perioperative slope from a steady-state single beat in patients with functional mitral regurgitation and assessed the correlation with brain natriuretic peptide (BNP) levels.

METHODS

The study included 16 patients with non-ischemic dilated cardiomyopathy and refractory heart failure: 10 patients underwent mitral valve plasty and left ventricular plasty (MVP + LVP group) and 6 patients who underwent mitral valve replacement and papillary muscle tugging approximation (MVR + PMTA group). The left ventricular ejection fraction was assessed by the modified Simpson method; the slope was assessed by the single-beat technique using transthoracic echocardiography. BNP levels were measured by chemiluminescent immunoassay.

RESULTS

The left ventricular ejection fraction and slope did not significantly change from pre- to early post-surgery in the MVP + LVP group. Both the left ventricular ejection fraction and slope significantly increased 6 months after surgery in the MVR + PMTA group. Postoperative BNP level was low in the MVR + PMTA group. While the postoperative left ventricular ejection fraction did not correlate with BNP levels, the postoperative slope significantly correlated with BNP level after surgery in the MVP + LVP group and in the total functional mitral regurgitation group.

CONCLUSIONS

The change of slope was dependent on surgical procedures. In functional mitral regurgitation, the slope may be a more sensitive parameter in reflecting the left ventricular contractile function than the left ventricular ejection fraction.

Authors+Show Affiliations

Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan. shingu@huhp.hokudai.ac.jp.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.Emergency and Clinical Care Center, Hokkaido University Hospital, Sapporo, Japan.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31230181

Citation

Ishigaki, Takahiro, et al. "Perioperative Changes of the Slope in the Preload Recruitable Stroke Work Relationship By a Single-beat Technique After Mitral Valve Surgery in Functional Mitral Regurgitation With Non-ischemic Dilated Cardiomyopathy." General Thoracic and Cardiovascular Surgery, vol. 68, no. 1, 2020, pp. 30-37.
Ishigaki T, Shingu Y, Katoh N, et al. Perioperative changes of the slope in the preload recruitable stroke work relationship by a single-beat technique after mitral valve surgery in functional mitral regurgitation with non-ischemic dilated cardiomyopathy. Gen Thorac Cardiovasc Surg. 2020;68(1):30-37.
Ishigaki, T., Shingu, Y., Katoh, N., Wakasa, S., Katoh, H., Ooka, T., ... Matsui, Y. (2020). Perioperative changes of the slope in the preload recruitable stroke work relationship by a single-beat technique after mitral valve surgery in functional mitral regurgitation with non-ischemic dilated cardiomyopathy. General Thoracic and Cardiovascular Surgery, 68(1), pp. 30-37. doi:10.1007/s11748-019-01164-w.
Ishigaki T, et al. Perioperative Changes of the Slope in the Preload Recruitable Stroke Work Relationship By a Single-beat Technique After Mitral Valve Surgery in Functional Mitral Regurgitation With Non-ischemic Dilated Cardiomyopathy. Gen Thorac Cardiovasc Surg. 2020;68(1):30-37. PubMed PMID: 31230181.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perioperative changes of the slope in the preload recruitable stroke work relationship by a single-beat technique after mitral valve surgery in functional mitral regurgitation with non-ischemic dilated cardiomyopathy. AU - Ishigaki,Takahiro, AU - Shingu,Yasushige, AU - Katoh,Nobuyasu, AU - Wakasa,Satoru, AU - Katoh,Hiroki, AU - Ooka,Tomonori, AU - Kubota,Suguru, AU - Matsui,Yoshiro, Y1 - 2019/06/22/ PY - 2019/03/20/received PY - 2019/06/16/accepted PY - 2019/6/24/pubmed PY - 2019/6/24/medline PY - 2019/6/24/entrez KW - Dilated cardiomyopathy KW - Mitral regurgitation KW - Preload recruitable stroke work relationship SP - 30 EP - 37 JF - General thoracic and cardiovascular surgery JO - Gen Thorac Cardiovasc Surg VL - 68 IS - 1 N2 - OBJECTIVES: The slope in the preload recruitable stroke work relationship is a highly linear, load-insensitive contractile parameter. However, the perioperative change of the slope has not been reported before. We examined the perioperative slope from a steady-state single beat in patients with functional mitral regurgitation and assessed the correlation with brain natriuretic peptide (BNP) levels. METHODS: The study included 16 patients with non-ischemic dilated cardiomyopathy and refractory heart failure: 10 patients underwent mitral valve plasty and left ventricular plasty (MVP + LVP group) and 6 patients who underwent mitral valve replacement and papillary muscle tugging approximation (MVR + PMTA group). The left ventricular ejection fraction was assessed by the modified Simpson method; the slope was assessed by the single-beat technique using transthoracic echocardiography. BNP levels were measured by chemiluminescent immunoassay. RESULTS: The left ventricular ejection fraction and slope did not significantly change from pre- to early post-surgery in the MVP + LVP group. Both the left ventricular ejection fraction and slope significantly increased 6 months after surgery in the MVR + PMTA group. Postoperative BNP level was low in the MVR + PMTA group. While the postoperative left ventricular ejection fraction did not correlate with BNP levels, the postoperative slope significantly correlated with BNP level after surgery in the MVP + LVP group and in the total functional mitral regurgitation group. CONCLUSIONS: The change of slope was dependent on surgical procedures. In functional mitral regurgitation, the slope may be a more sensitive parameter in reflecting the left ventricular contractile function than the left ventricular ejection fraction. SN - 1863-6713 UR - https://www.unboundmedicine.com/medline/citation/31230181/Perioperative_changes_of_the_slope_in_the_preload_recruitable_stroke_work_relationship_by_a_single-beat_technique_after_mitral_valve_surgery_in_functional_mitral_regurgitation_with_non-ischemic_dilated_cardiomyopathy L2 - https://dx.doi.org/10.1007/s11748-019-01164-w DB - PRIME DP - Unbound Medicine ER -