2024-03-29T01:51:30Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/800892022-11-17T02:08:08Zhdl_2115_20040hdl_2115_121Perioperative 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 cardiomyopathyIshigaki, TakahiroShingu, YasushigeKatoh, NobuyasuWakasa, SatoruKatoh, HirokiOoka, TomonoriKubota, SuguruMatsui, YoshiroMitral regurgitationDilated cardiomyopathyPreload recruitable stroke work relationship490Objectives: 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.SpringerJournal Articleapplication/pdfhttp://hdl.handle.net/2115/80089https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/80089/2/Gen%20Thorac%20Cardiovasc%20Surg_2019.pdf1863-67051863-6713General Thoracic and Cardiovascular Surgery6830372020-01enginfo:doi/10.1007/s11748-019-01164-wThis is a post-peer-review, pre-copyedit version of an article published in General thoracic and cardiovascular surgery. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11748-019-01164-wauthor