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The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation

BACKGROUND: We evaluated whether the number of myocardial infarction (MI) segments connected to the papillary muscle (PM), as assessed using cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE), predicts whether moderate ischemic mitral regurgitation (IMR) improves after isolated...

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Autores principales: Zhang, Kui, Fu, Wei, Dai, Qinyi, Zheng, Jubing, Biekan, Jumatay, Wang, Yueli, Yan, Pengyun, Gu, Xiaoyan, Mu, Junsheng, Dong, Ran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808117/
https://www.ncbi.nlm.nih.gov/pubmed/36605082
http://dx.doi.org/10.21037/cdt-22-301
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author Zhang, Kui
Fu, Wei
Dai, Qinyi
Zheng, Jubing
Biekan, Jumatay
Wang, Yueli
Yan, Pengyun
Gu, Xiaoyan
Mu, Junsheng
Dong, Ran
author_facet Zhang, Kui
Fu, Wei
Dai, Qinyi
Zheng, Jubing
Biekan, Jumatay
Wang, Yueli
Yan, Pengyun
Gu, Xiaoyan
Mu, Junsheng
Dong, Ran
author_sort Zhang, Kui
collection PubMed
description BACKGROUND: We evaluated whether the number of myocardial infarction (MI) segments connected to the papillary muscle (PM), as assessed using cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE), predicts whether moderate ischemic mitral regurgitation (IMR) improves after isolated coronary artery bypass grafting (CABG) to guide the choice of surgical strategy. METHODS: A total of 54 patients diagnosed with coronary heart disease (CHD) complicated with moderate IMR who underwent isolated CABG were selected continuously in this retrospective study at Beijing Anzhen Hospital. All patients underwent preoperative LGE. The patients were divided into the IMR improved group (37 patients) and the unimproved group (17 patients) according to 1-year postoperative echocardiography. The factors associated with no IMR improvement after isolated CABG were analyzed. There was no trial registration and no publication of the study protocol. RESULTS: The number of MI segments connected to PM was an independent risk factor for no IMR improvement after isolated CABG [odds ratio 4.39; 95% confidence interval (CI): 1.93–9.98; P<0.001]. The optimal receiver operating characteristic (ROC) curve cut-off value for no IMR improvement was ≥2 (sensitivity: 82.4%; specificity: 83.8%). Follow-up at 1–5 years (median, 2.8 years) showed that the incidences of major adverse cardiovascular and cerebrovascular events (5.4% vs. 23.5%; P=0.041) and New York Heart Association (NYHA) grade (P=0.026) were higher in the unimproved group. CONCLUSIONS: In patients with CHD complicated with moderate IMR, the number of MI segments connected to PM is an independent risk factor for no IMR improvement after isolated CABG. Mitral valve surgery should be performed simultaneously with CABG in patients with ≥2 MI segments connected to the PM.
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spelling pubmed-98081172023-01-04 The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation Zhang, Kui Fu, Wei Dai, Qinyi Zheng, Jubing Biekan, Jumatay Wang, Yueli Yan, Pengyun Gu, Xiaoyan Mu, Junsheng Dong, Ran Cardiovasc Diagn Ther Original Article BACKGROUND: We evaluated whether the number of myocardial infarction (MI) segments connected to the papillary muscle (PM), as assessed using cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE), predicts whether moderate ischemic mitral regurgitation (IMR) improves after isolated coronary artery bypass grafting (CABG) to guide the choice of surgical strategy. METHODS: A total of 54 patients diagnosed with coronary heart disease (CHD) complicated with moderate IMR who underwent isolated CABG were selected continuously in this retrospective study at Beijing Anzhen Hospital. All patients underwent preoperative LGE. The patients were divided into the IMR improved group (37 patients) and the unimproved group (17 patients) according to 1-year postoperative echocardiography. The factors associated with no IMR improvement after isolated CABG were analyzed. There was no trial registration and no publication of the study protocol. RESULTS: The number of MI segments connected to PM was an independent risk factor for no IMR improvement after isolated CABG [odds ratio 4.39; 95% confidence interval (CI): 1.93–9.98; P<0.001]. The optimal receiver operating characteristic (ROC) curve cut-off value for no IMR improvement was ≥2 (sensitivity: 82.4%; specificity: 83.8%). Follow-up at 1–5 years (median, 2.8 years) showed that the incidences of major adverse cardiovascular and cerebrovascular events (5.4% vs. 23.5%; P=0.041) and New York Heart Association (NYHA) grade (P=0.026) were higher in the unimproved group. CONCLUSIONS: In patients with CHD complicated with moderate IMR, the number of MI segments connected to PM is an independent risk factor for no IMR improvement after isolated CABG. Mitral valve surgery should be performed simultaneously with CABG in patients with ≥2 MI segments connected to the PM. AME Publishing Company 2022-12 /pmc/articles/PMC9808117/ /pubmed/36605082 http://dx.doi.org/10.21037/cdt-22-301 Text en 2022 Cardiovascular Diagnosis and Therapy. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Zhang, Kui
Fu, Wei
Dai, Qinyi
Zheng, Jubing
Biekan, Jumatay
Wang, Yueli
Yan, Pengyun
Gu, Xiaoyan
Mu, Junsheng
Dong, Ran
The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation
title The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation
title_full The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation
title_fullStr The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation
title_full_unstemmed The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation
title_short The number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation
title_sort number of myocardial infarction segments connected to papillary muscle is associated with the improvement in moderate ischemic mitral regurgitation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808117/
https://www.ncbi.nlm.nih.gov/pubmed/36605082
http://dx.doi.org/10.21037/cdt-22-301
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