PMID- 34532465
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220426
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 9
IP  - 16
DP  - 2021 Aug
TI  - The association between myocardial scar and the response of moderate ischemic 
      mitral regurgitation to isolated coronary artery bypass grafting.
PG  - 1328
LID - 10.21037/atm-21-3622 [doi]
LID - 1328
AB  - BACKGROUND: The factors that associated with the response of moderate ischemic 
      mitral regurgitation (IMR) to isolated coronary artery bypass grafting (CABG) 
      remain unclear. This study aims to evaluate whether left ventricular (LV) 
      myocardial scar assessed by cardiovascular magnetic resonance (CMR) is associated 
      with the outcome of moderate IMR after isolated CABG. METHODS: Forty-six patients 
      with coronary artery disease (CAD) and moderate IMR who underwent isolated CABG 
      between January 2014 and February 2019 in Anzhen Hospital Affiliated to Capital 
      Medical University were enrolled in this case-control study. All patients 
      underwent CMR and echocardiography before surgery. Patients were classified into 
      two groups according to the severity of IMR 1 year after CABG: an improved group 
      (no or mild IMR) and an unimproved group (moderate or severe IMR). Univariate and 
      multivariate logistic regression analyses were used to assess the association 
      between individual variables and unimproved IMR at 1-year post-CABG. RESULTS: 
      Compared to patients in the improved group, the patients in the unimproved group 
      had a significantly greater amount of LV myocardial scar (18.0%+/-9.5% vs. 
      30.8%+/-11.2%, P<0.001). In the multiple logistic regression model, after 
      adjustment for age, sex, and body mass index, only LV myocardial scar (OR: 0.89, 
      95% CI: 0.83-0.96, P=0.001) was independently associated with unimproved IMR 
      after isolated CABG. Furthermore, there was no difference in the 3-year overall 
      survival rates between the two groups (92.3% vs. 90.3%, P=0.46). In addition, 
      patients in the unimproved group had a higher New York Heart Association (NYHA) 
      classification (P=0.01) and more major adverse cardiac events such as MI, angina 
      pectoris, and readmission for heart failure (P=0.03). CONCLUSIONS: A greater 
      amount of preoperative LV myocardial scar was associated with unimproved moderate 
      IMR after isolated CABG. Measuring preoperative LV myocardial scar is helpful to 
      predict post-operative outcome and determine optimal surgery in patients with 
      moderate IMR.
CI  - 2021 Annals of Translational Medicine. All rights reserved.
FAU - Zhu, Enjun
AU  - Zhu E
AD  - Department of Cardiovascular Surgery, Anzhen Hospital Affiliated to Capital 
      Medical University, Beijing, China.
FAU - Zhang, Chen
AU  - Zhang C
AD  - Department of Radiology, Anzhen Hospital Affiliated to Capital Medical 
      University, Beijing, China.
FAU - Wang, Shengwei
AU  - Wang S
AD  - Department of Cardiovascular Surgery, Anzhen Hospital Affiliated to Capital 
      Medical University, Beijing, China.
FAU - Ma, Xiaohai
AU  - Ma X
AD  - Department of Interventional Diagnosis and Treatment, Anzhen Hospital Affiliated 
      to Capital Medical University, Beijing, China.
FAU - Lai, Yongqiang
AU  - Lai Y
AD  - Department of Cardiovascular Surgery, Anzhen Hospital Affiliated to Capital 
      Medical University, Beijing, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC8422129
OTO - NOTNLM
OT  - Coronary artery disease (CAD)
OT  - cardiovascular magnetic resonance (CMR)
OT  - ischemic mitral regurgitation (IMR)
OT  - myocardial scar
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at https://dx.doi.org/10.21037/atm-21-3622). The authors have no 
      conflicts of interest to declare.
EDAT- 2021/09/18 06:00
MHDA- 2021/09/18 06:01
PMCR- 2021/08/01
CRDT- 2021/09/17 07:19
PHST- 2021/06/18 00:00 [received]
PHST- 2021/08/20 00:00 [accepted]
PHST- 2021/09/17 07:19 [entrez]
PHST- 2021/09/18 06:00 [pubmed]
PHST- 2021/09/18 06:01 [medline]
PHST- 2021/08/01 00:00 [pmc-release]
AID - atm-09-16-1328 [pii]
AID - 10.21037/atm-21-3622 [doi]
PST - ppublish
SO  - Ann Transl Med. 2021 Aug;9(16):1328. doi: 10.21037/atm-21-3622.