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Prognostic Value of Late Gadolinium Enhancement in Postoperative Morbidity following Mitral Valve Surgery in

Teuku Muhammad Haykal Putra1, Renan Sukmawan1, Elen Elen1

  • 1Department of Cardiology and Vascular Medicine, Division of Nuclear Cardiology and Cardiovascular Imaging, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|December 3, 2019
PubMed

Insights

Myocardial fibrosis, a scarring of heart muscle, is common in rheumatic mitral stenosis patients undergoing valve surgery. Higher fibrosis levels correlate with increased postoperative complications, highlighting its prognostic significance.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Rheumatic mitral stenosis (MS) involves chronic inflammation leading to myocardial fibrosis.
  • Myocardial fibrosis is a known predictor of adverse outcomes in various cardiac conditions.
  • The prognostic impact of myocardial fibrosis in rheumatic MS patients undergoing mitral valve surgery remains underexplored.

Purpose of the Study:

  • To investigate the prognostic value of myocardial fibrosis in predicting postoperative morbidity after mitral valve surgery in patients with rheumatic MS.

Main Methods:

  • Prospective observational study of 47 consecutive rheumatic MS patients.
  • Preoperative cardiac magnetic resonance imaging (CMR) with late gadolinium enhancement (LGE) assessed left ventricular myocardial fibrosis.
  • Patients were monitored for postoperative morbidities including stroke, renal failure, and prolonged mechanical ventilation.

Main Results:

  • Preoperative myocardial fibrosis was detected in 91.5% of patients, with a median fibrosis volume of 2.8%.
  • Postoperative morbidities occurred in 23.4% of patients.
  • A significant association was found between higher myocardial fibrosis volume and increased postoperative morbidity (5.97% vs. 3.12%, p=0.04).

Conclusions:

  • Extensive myocardial fibrosis is linked to a higher risk of postoperative morbidity in rheumatic MS patients undergoing mitral valve surgery.
  • Myocardial fibrosis assessment may aid in risk stratification for these patients.
  • Further research is warranted to elucidate the mechanisms linking fibrosis to adverse outcomes.
Keywords:
mitral valve surgerymyocardial fibrosisrheumatic heart disease

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