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An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation

BACKGROUND: It is difficult to determine left ventricular systolic performance in patients with severe mitral regurgitation (MR) since left ventricular ejection fraction (EF) could be preserved until the end stages of the disease. Myocardial efficiency (MEf) describes the amount of external work (EW...

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Autores principales: Güvenç, Rengin Çetin, Aruğaslan, Emre, Güvenç, Tolga Sinan, Karadeniz, Fatma Özpamuk, Kaşıkçıoğlu, Hülya, Çam, Neşe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Echocardiography 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7572264/
https://www.ncbi.nlm.nih.gov/pubmed/33086443
http://dx.doi.org/10.4250/jcvi.2020.0038
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author Güvenç, Rengin Çetin
Aruğaslan, Emre
Güvenç, Tolga Sinan
Karadeniz, Fatma Özpamuk
Kaşıkçıoğlu, Hülya
Çam, Neşe
author_facet Güvenç, Rengin Çetin
Aruğaslan, Emre
Güvenç, Tolga Sinan
Karadeniz, Fatma Özpamuk
Kaşıkçıoğlu, Hülya
Çam, Neşe
author_sort Güvenç, Rengin Çetin
collection PubMed
description BACKGROUND: It is difficult to determine left ventricular systolic performance in patients with severe mitral regurgitation (MR) since left ventricular ejection fraction (EF) could be preserved until the end stages of the disease. Myocardial efficiency (MEf) describes the amount of external work (EW) done by the left ventricle per unit of oxygen consumed (mVO(2)). In the present study, we aimed to investigate MEf in patients with asymptomatic severe MR using a novel echocardiographic method. METHODS: A total of 27 patients with severe asymptomatic MR and 26 healthy volunteers were included in this cross-sectional study. EW was measured using stroke volume and blood pressure, while mVO(2) was estimated using double product and left ventricular mass. RESULTS: There were no differences between the groups with regards to EF (66% ± 5% vs. 69% ± 7%), while MEf was significantly reduced in patients with severe MR (25% ± 11% vs. 44% ± 12%, p < 0.001). This difference was maintained even after adjustment for age, gender and body surface area (adjusted [Formula: see text]: 0.44, 95% CI: 0.39–0.49 for controls and adjusted [Formula: see text]: 0.24, 95% CI: 0.19–0.29 for patients with severe MR). Further analysis showed that this reduction was due to an increase in total mVO(2) in the severe MR group. MEf of thepatients who were both on β-blockers and angiotensin converting enzyme inhibitors/angiotensin receptor blockers were higher than those who were not on any drugs, but this difference was not statistically significant (32% ± 15% vs. 23% ± 9%, p = 0.41). CONCLUSIONS: MEf was significantly lower in patients with asymptomatic severe MR and preserved EF.
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spelling pubmed-75722642020-10-23 An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation Güvenç, Rengin Çetin Aruğaslan, Emre Güvenç, Tolga Sinan Karadeniz, Fatma Özpamuk Kaşıkçıoğlu, Hülya Çam, Neşe J Cardiovasc Imaging Original Article BACKGROUND: It is difficult to determine left ventricular systolic performance in patients with severe mitral regurgitation (MR) since left ventricular ejection fraction (EF) could be preserved until the end stages of the disease. Myocardial efficiency (MEf) describes the amount of external work (EW) done by the left ventricle per unit of oxygen consumed (mVO(2)). In the present study, we aimed to investigate MEf in patients with asymptomatic severe MR using a novel echocardiographic method. METHODS: A total of 27 patients with severe asymptomatic MR and 26 healthy volunteers were included in this cross-sectional study. EW was measured using stroke volume and blood pressure, while mVO(2) was estimated using double product and left ventricular mass. RESULTS: There were no differences between the groups with regards to EF (66% ± 5% vs. 69% ± 7%), while MEf was significantly reduced in patients with severe MR (25% ± 11% vs. 44% ± 12%, p < 0.001). This difference was maintained even after adjustment for age, gender and body surface area (adjusted [Formula: see text]: 0.44, 95% CI: 0.39–0.49 for controls and adjusted [Formula: see text]: 0.24, 95% CI: 0.19–0.29 for patients with severe MR). Further analysis showed that this reduction was due to an increase in total mVO(2) in the severe MR group. MEf of thepatients who were both on β-blockers and angiotensin converting enzyme inhibitors/angiotensin receptor blockers were higher than those who were not on any drugs, but this difference was not statistically significant (32% ± 15% vs. 23% ± 9%, p = 0.41). CONCLUSIONS: MEf was significantly lower in patients with asymptomatic severe MR and preserved EF. Korean Society of Echocardiography 2020-10 2020-07-10 /pmc/articles/PMC7572264/ /pubmed/33086443 http://dx.doi.org/10.4250/jcvi.2020.0038 Text en Copyright © 2020 Korean Society of Echocardiography https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Güvenç, Rengin Çetin
Aruğaslan, Emre
Güvenç, Tolga Sinan
Karadeniz, Fatma Özpamuk
Kaşıkçıoğlu, Hülya
Çam, Neşe
An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation
title An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation
title_full An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation
title_fullStr An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation
title_full_unstemmed An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation
title_short An Analysis of Myocardial Efficiency in Patients with Severe Asymptomatic Mitral Regurgitation
title_sort analysis of myocardial efficiency in patients with severe asymptomatic mitral regurgitation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7572264/
https://www.ncbi.nlm.nih.gov/pubmed/33086443
http://dx.doi.org/10.4250/jcvi.2020.0038
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