[en] AIMS: The management of asymptomatic patients with mitral regurgitation (MR) remains controversial. Exercise-induced pulmonary hypertension (ExPHT) was recently reported as a strong predictor of rapid onset of symptoms. We hypothesised that ExPHT is a predictor of postoperative cardiovascular events in patients with primary MR. METHODS AND RESULTS: One hundred and two patients with primary MR, no or mild symptoms (New York heart association (NYHA) 60 mm Hg. All patients were closely followed up and operated on when indication for surgery was reached. Postoperative events were defined as the occurrence of atrial fibrillation (AF), stroke, cardiac-related hospitalisation or death. Among the 102 patients included, 59 developed ExPHT (58%). These patients were significantly older than those without ExPHT (p=0.01). During a mean postoperative follow-up of 50+/-23 months, 28 patients (26%) experienced a predefined cardiovascular event. Patients with ExPHT had significantly higher rate of postoperative events (39% vs 12%, p=0.005); the rate of events was still higher in these patients (32% vs 9%, p=0.013), even when excluding early postoperative AF (ie, within 48 h). Event-free survival was significantly lower in the ExPHT group (all events: 5-year: 60+/-8% vs 88+/-5%, p=0.007, events without early AF: 5-year: 67+/-7% vs 90+/-4%, p=0.02). Using Cox multivariable analysis, ExPHT remained independently associated with higher risk of postoperative events in all models (all p
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Magne, J.; Department of Cardiology, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
Donal, Erwan; Cardiologie and CIC-IT U 804, Centre Hospitalier Universitaire de Rennes, Rennes, France, LTSI, Université Rennes1, INSERM 1099, Rennes, France
Mahjoub, H.; Quebec Heart and Lung Institute, Quebec, Canada
Miltner, B.; Department of Cardiology, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
DULGHERU, Raluca Elena ; Centre Hospitalier Universitaire de Liège - CHU > Service de cardiologie
Thebault, C.; Cardiologie and CIC-IT U 804, Centre Hospitalier Universitaire de Rennes, Rennes, France, LTSI, Université Rennes1, INSERM 1099, Rennes, France
Pierard, Luc ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Pibarot, P.; Quebec Heart and Lung Institute, Quebec, Canada
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Imagerie cardiaque fonctionnelle par échographie
Language :
English
Title :
Impact of exercise pulmonary hypertension on postoperative outcome in primary mitral regurgitation.
Publication date :
2015
Journal title :
Heart
ISSN :
1355-6037
eISSN :
1468-201X
Publisher :
BMJ Publishing Group, United Kingdom
Volume :
101
Issue :
5
Pages :
391-396
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
MOP # 102737, CIHR, Canadian Institutes of Health Research
Commentary :
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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