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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

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/80089

Title: 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
Authors: Ishigaki, Takahiro Browse this author
Shingu, Yasushige Browse this author →KAKEN DB
Katoh, Nobuyasu Browse this author
Wakasa, Satoru Browse this author →KAKEN DB
Katoh, Hiroki Browse this author
Ooka, Tomonori Browse this author →KAKEN DB
Kubota, Suguru Browse this author →KAKEN DB
Matsui, Yoshiro Browse this author →KAKEN DB
Keywords: Mitral regurgitation
Dilated cardiomyopathy
Preload recruitable stroke work relationship
Issue Date: Jan-2020
Publisher: Springer
Journal Title: General Thoracic and Cardiovascular Surgery
Volume: 68
Start Page: 30
End Page: 37
Publisher DOI: 10.1007/s11748-019-01164-w
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.
Rights: This 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-w
Type: article (author version)
URI: http://hdl.handle.net/2115/80089
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 新宮 康栄

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