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Preoperative and postoperative right ventricular function during exercise in patients with mitral stenosis
N Hirata1, T Sakakibara, Y Shimazaki
1Cardiovascular Division, Osaka Police Hospital, Japan.
The Journal of Thoracic and Cardiovascular Surgery
|October 1, 1992
Summary
Mitral valve surgery improved right ventricular diastolic function in all patients and systolic function in half. Elevated pulmonary vascular resistance predicted persistent right ventricular systolic dysfunction post-surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Imaging
Background:
- Mitral stenosis can impair right ventricular (RV) function.
- The impact of mitral valve surgery on RV function requires further elucidation.
Purpose of the Study:
- To assess the effects of mitral valve surgery on RV systolic and diastolic function at rest and during exercise in patients with mitral stenosis.
Main Methods:
- Gated equilibrium blood pool radionuclide ventriculography was used to quantify RV function (ejection fraction, peak ejection rate, peak filling rate) pre- and post-surgery in 11 patients.
- Measurements were performed at rest and during exercise.
Main Results:
- Postoperative RV ejection fraction during exercise improved in patients with preoperative RV ejection fraction ≥ 40% and normalized in about half of all patients.
- RV peak ejection rate and peak filling rate during exercise increased to normal levels post-surgery in all patients.
- Preoperative RV dysfunction changes during exercise correlated inversely with pulmonary vascular resistance.
Conclusions:
- Mitral valve surgery improves RV diastolic function in all patients and systolic function in approximately half.
- Persistent RV systolic dysfunction post-surgery is associated with elevated preoperative pulmonary vascular resistance.