Clinical Impact of Flow Adjusted Transmitral Pressure Gradient After Surgical Annuloplasty for Functional Mitral Regurgitation

Flow adjusted transmitral pressure gradient as a modified indicator of functional mitral stenosis after repair for degenerative mitral regurgitation

“…Standard transthoracic echocardiography was performed on all patients in the left lateral decubitus position by experienced sonographers before and after symptom‐limited exercise, using a commercially available ultrasound machine (Aplio Artida, Toshiba Medical Systems Corporation). Standard data, such as left ventricular ejection fraction (LVEF), end‐diastolic and systolic dimensions, and tricuspid regurgitation pressure gradient (TRPG) were obtained from the official echocardiographic report 13 . Stroke volume was measured from the LV outflow tract (LVOT) area × LVOT velocity time integral (VTI) by the pulse wave Doppler method.…”

“…Standard data, such as left ventricular ejection fraction (LVEF), end-diastolic and systolic dimensions, and tricuspid regurgitation pressure gradient (TRPG) were obtained from the official echocardiographic report. 13 Stroke volume was measured from the LV outflow tract (LVOT) area × LVOT velocity time integral (VTI) by the pulse wave Doppler method. To evaluate the hemodynamic status of the mitral valve, EOA calculated with the continuity equation, peak and mean TMPG, Doppler velocity index (DVI = VTI MV /VTI LVOT ), and peak flow velocity was measured based on standard guidelines.…”

“…We have recently reported that conventional mitral hemodynamic parameters were not associated with adverse cardiac events after annuloplasty for ischemic functional MR. However, flow adjusted TMPG was identified as an independent predictor, and risk stratification by peak TMPG and LVSV predicted midterm outcomes well 13 . Flow adjusted TMPG may be applied as a predictor of clinical outcomes, even though the left ventricular function is usually preserved in patients with DMR.…”

“…However, flow adjusted TMPG was identified as an independent predictor, and risk stratification by peak TMPG and LVSV predicted midterm outcomes well. 13 Flow adjusted TMPG may be applied as a predictor of clinical outcomes, even though the left ventricular function is usually preserved in patients with DMR.…”