Surgical Strategy for Moderate Ischemic Mitral Valve Regurgitation: Repair or Ignore?

2014 ◽  
Vol 17 (4) ◽  
pp. 201 ◽  
Author(s):  
Adem İ Diken ◽  
Garip Altıntaş ◽  
Adnan Yalçınkaya ◽  
Gökhan Lafçı ◽  
Onur Hanedan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Intervention Group ◽  
Control Group ◽  
Artery Pressure ◽  
Artery Disease

<p><strong>Background:</strong> Ischemic heart disease is a significant complication of atherosclerosis. Myocardial infarction after the development of coronary artery disease can lead to a number of serious complications, including ischemic mitral regurgitation (IMR). Currently there is no consensus regarding the preferred therapeutic modality for moderately severe IMR. In this study, the postoperative outcome of concomitant coronary artery bypass (CABG) and mitral valve repair was compared with that of CABG alone in two groups of patients with moderately severe IMR.</p><p><strong>Methods:</strong> A total of 84 patients who underwent operations for coronary artery disease and moderately severe IMR were included in the study. Preoperative demographic and clinical characteristics were recorded at the time of admission. The severity of mitral regurgitation was graded using transthoracic echocardiography and left ventriculography.</p><p><strong>Results:</strong> Significant postoperative improvements were observed in ejection fraction and systolic diameter compared to preoperative values (<em>P</em> = .006 and <em>P</em> = .020 respectively, in the intervention group, <em>P</em> = .001 and <em>P</em> = .001 respectively, in the control group). The decrease in pulmonary artery pressure (PAP) was significant only in the intervention group (<em>P</em> = .001). There was a significantly marked reduction in the severity of IMR in the intervention group compared to control.</p><p><strong>Conclusion:</strong> Surgical repair of the mitral valve in conjunction with CABG for moderately severe IMR appears to be more effective than isolated CABG for certain outcome parameters, including decreased severity of mitral regurgitation and decreased pulmonary artery pressure.</p>

Fatty Acid Metabolism in Symptomatic Patients with Mitral Valve Prolapse but without Coronary Artery Disease - Comparison with 201 Tl Myocardial Perfusion Scintigraphy

1987 ◽  
Vol 26 (04) ◽  
pp. 172-176 ◽  
Author(s):  
H. Schicha ◽  
U. Tebbei ◽  
P. Neumann ◽  
D. Emrich ◽  
E. Voth
Keyword(s):  
Coronary Artery Disease ◽  
Fatty Acid ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Acid Metabolism ◽  
Myocardial Perfusion Scintigraphy ◽  
Control Group ◽  
Perfusion Scintigraphy ◽  
Elimination Half ◽  
Artery Disease

Using 123l-ω-heptadecanoic acid (HDA) and 201TI, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination halflife was 26.1 ± 3.6 min, whereas the patients with MVP had a mean value of ± 6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31 % and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201TI showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201TI, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism.

Comparative morbidity of mitral valve repair versus replacement for mitral regurgitation with and without coronary artery disease

1995 ◽  
Vol 60 (5) ◽  
pp. 1452-1453 ◽  
Author(s):  
Lawrence H. Cohn ◽  
Wendy Kowalker ◽  
Satinder Bhatia ◽  
Verdi J. DiSesa ◽  
Martin St. John-Sutton ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Artery Disease

scholarly journals The Effect of Intensive Dietary Intervention on the Level of RANTES and CXCL4 Chemokines in Patients with Non-Obstructive Coronary Artery Disease: A Randomised Study

Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 156
Author(s):  
Magdalena Makarewicz-Wujec ◽  
Jan Henzel ◽  
Mariusz Kruk ◽  
Cezary Kępka ◽  
Łukasz Wardziak ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Dietary Intervention ◽  
Obstructive Coronary Artery Disease ◽  
Intervention Group ◽  
Control Group ◽  
Pathophysiological Mechanism ◽  
Study Objective ◽  
Dash Diet ◽  
Artery Disease

Background: Inflammation is the key pathophysiological mechanism of the initiation and progression of atherosclerosis. The study objective was to assess the effects of a dietary intervention based on the model of the dietary approaches to stop hypertension (DASH) diet on the levels of chemokines RANTES and CXCL4 in patients with non-obstructive coronary artery disease. Methods: As part of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40), where the DASH diet was introduced along with optimal pharmacotherapy, and to a control group (n = 39), with optimal pharmacotherapy alone. In the DASH group, systematic dietary counselling was provided for the follow-up period. RANTES and CXCL4 levels were determined using ELISA. Results: In the DASH group, the RANTES level insignificantly reduced from 42.70 ± 21.1 ng/mL to 38.09 ± 18.5 ng/mL (p = 0.134), and the CXCL4 concentration significantly reduced from 12.38 ± 4.1 ng/mL to 8.36 ± 2.3 ng/mL (p = 0.0001). At the same time, an increase in the level of both chemokines was observed in the control group: RANTES from 34.69 ± 22.7 to 40.94 ± 20.0 ng/mL (p = 0.06) and CXCL4 from 10.98 ± 3.6 to 13.0 5± 4.8 ng/mL (p = 0.009). The difference between the changes in both groups was significant for both RANTES (p = 0.03) and CXCL4 (p = 0.00001). The RANTES/CXCL4 ratio reduced in the control group (from 3.52 ± 2.8 to 3.35 ± 2.8; p = 0.006), while in the DASH group, an increase was observed (from 3.54 ± 1.7 to 4.77 ± 2.4; p = 0.001). Conclusions: A 12-month-long intensive dietary intervention based on DASH diet guidelines as an addition to optimal pharmacotherapy causes changes in the levels of chemokines CXCL4 and RANTES and their mutual relationship in comparison to conventional treatment.

scholarly journals Simple and Short-term Inspiration Training Accelerates Recovery from Residual Pulmonary Hypertension after Mitral Valve Surgery: A randomized control trial

2021 ◽  
Author(s):  
Basuni Radi Radi ◽  
Bima Suryaatmaja ◽  
Ario Suryo Kuncoro ◽  
Amiliana M Soesanto
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Intervention Group ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Control Group ◽  
Muscle Training ◽  
Residual Pulmonary Hypertension

Background: Residual pulmonary hypertension after mitral valve surgery predicts a worse prognosis. This study aimed to explore the effect of inspiratory muscle training on functional capacity and pulmonary artery pressure in patients with residual pulmonary hypertension after mitral valve surgery. Methods: Forty-three patients with residual pulmonary hypertension soon after mitral valve repair or replacement surgery were consecutively enrolled in this randomised controlled trial. They were randomly allocated to either an intervention group (n=22) or a control group (n=21). Both groups participated in usual 10-12 sessions of supervised aerobic exercise training, with low to moderate intensity. The subjects in the intervention group participated in additional inspiratory muscle training using an incentive spirometer with a series of 10-12 inspiration repetitions of 50% of maximum inspiratory volume in each aerobic session. Echocardiography and the 6-minute walking test were performed before and after the programme. Results: The patients were 70% female, mean age 43.5+/-13 years. Both groups had similar baseline characteristics. The systolic pulmonary artery pressure declined from 51(43-68) mmHg to 35 (29-39) mmHg, p<0.001 in intervention group, and from 46(43-55) mmHg to  43(40-51)mmHg, p<0.01 in control group. The reduction was higher in the intervention group than in the control group, 16 (12-30) vs 3.5 (2-4) mmHg respectively, p<0.001, and in patients with higher baseline systolic pulmonary artery pressure. The 6-minute walk test distance increased from 308(242-353) meters to 407(377-433) meter, p<0.01 in intervention group, and from 353(334-381) meter to 391(376-429) meter, p<0.01 in control group. The improvement was higher in the intervention group than in control group, 101 (93-131) vs 48 (35-53) meter respectively, p<0.001. Conclusion: Adding inspiratory muscle training to a usual exercise programme resulted in faster recovery from residual pulmonary hypertension and higher increase in functional capacity.

scholarly journals The Effect of a WeChat-Based Tertiary A-Level Hospital Intervention on Medication Adherence and Risk Factor Control in Patients With Stable Coronary Artery Disease: Multicenter Prospective Study (Preprint)

2021 ◽  
Author(s):  
Boqun Shi ◽  
Xi Liu ◽  
Qiuting Dong ◽  
Yuxiu Yang ◽  
Zhongxing Cai ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medication Adherence ◽  
Stable Coronary Artery Disease ◽  
Intervention Group ◽  
Control Group ◽  
Artery Disease ◽  
Multicenter Prospective Study ◽  
Level Hospital

BACKGROUND In China, ischemic heart disease is the main cause of mortality. Having cardiac rehabilitation and a secondary prevention program in place is a class IA recommendation for individuals with coronary artery disease. WeChat-based interventions seem to be feasible and efficient for the follow-up and management of chronic diseases. OBJECTIVE This study aims to evaluate the effectiveness of a tertiary A-level hospital, WeChat-based telemedicine intervention in comparison with conventional community hospital follow-up on medication adherence and risk factor control in individuals with stable coronary artery disease. METHODS In this multicenter prospective study, 1424 patients with stable coronary artery disease in Beijing, China, were consecutively enrolled between September 2018 and September 2019 from the Fuwai Hospital and 4 community hospitals. At 1-, 3-, 6-, and 12-month follow-up, participants received healthy lifestyle recommendations and medication advice. Subsequently, the control group attended an offline outpatient clinic at 4 separate community hospitals. The intervention group had follow-up visits through WeChat-based telemedicine management. The main end point was medication adherence, which was defined as participant compliance in taking all 4 cardioprotective medications that would improve the patient’s outcome (therapies included antiplatelet therapy, β-blockers, statins, and angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers). Multivariable generalized estimating equations were used to compare the primary and secondary outcomes between the 2 groups and to calculate the relative risk (RR) at 12 months. Propensity score matching and inverse probability of treatment weighting were performed as sensitivity analyses, and propensity scores were calculated using a multivariable logistic regression model. RESULTS At 1 year, 88% (565/642) of patients in the intervention group and 91.8% (518/564) of patients in the control group had successful follow-up data. We matched 257 pairs of patients between the intervention and control groups. There was no obvious advantage in medication adherence with the 4 cardioprotective drugs in the intervention group (172/565, 30.4%, vs 142/518, 27.4%; RR 0.99, 95% CI 0.97-1.02; <i>P</i>=.65). The intervention measures improved smoking cessation (44/565, 7.8%, vs 118/518, 22.8%; RR 0.48, 95% CI 0.44-0.53; <i>P</i>&lt;.001) and alcohol restriction (33/565, 5.8%, vs 91/518, 17.6%; RR 0.47, 95% CI 0.42-0.54; <i>P</i>&lt;.001). CONCLUSIONS The tertiary A-level hospital, WeChat-based intervention did not improve adherence to the 4 cardioprotective medications compared with the traditional method. Tertiary A-level hospital, WeChat-based interventions have a positive effect on improving lifestyle, such as quitting drinking and smoking, in patients with stable coronary artery disease and can be tried as a supplement to community hospital follow-up. CLINICALTRIAL ClinicalTrials.gov NCT04795505; https://clinicaltrials.gov/ct2/show/NCT04795505

scholarly journals Benson’s Relaxation for Fatigue Patient with Coronary Artery Disease

2020 ◽  
Vol 2 (1) ◽  
pp. 63-69
Author(s):  
Mulyanti Roberto Muliantino ◽  
Tuti Herawati ◽  
Masfuri
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Recovery Period ◽  
Intervention Group ◽  
Relaxation Technique ◽  
Pharmacological Intervention ◽  
Control Group ◽  
Artery Disease ◽  
And Control

Fatigue is the major symptoms in patients with coronary artery disease, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to reduce fatigue, however few studies related to this technique in planned intervention. This study was to measure the effectiveness of Benson’s relaxation in fatigue of coronary artery disease patients during cardiac rehabilitation. It was a quasi-experimental pretest posttest control group design. This study included 29 respondents in Dr.M. Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). Benson’s relaxation technique was administered for 5 days 2 times a day, each 20 minutes to intervention group. Fatigue was measured using Maastricht Questionnaire (MQ). The result indicated significant reduction in mean of fatigue between intervention and control group (p value < 0,001). The study concluded that Benson’s relaxation technique is an effective non-pharmacological intervention to reduce fatigue in coronary artery disease patients. Keywords: Benson’s relaxation; fatigue; coronary artery disease

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