PMID- 36605082
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230111
IS  - 2223-3652 (Print)
IS  - 2223-3660 (Electronic)
IS  - 2223-3652 (Linking)
VI  - 12
IP  - 6
DP  - 2022 Dec
TI  - The number of myocardial infarction segments connected to papillary muscle is 
      associated with the improvement in moderate ischemic mitral regurgitation.
PG  - 828-839
LID - 10.21037/cdt-22-301 [doi]
AB  - BACKGROUND: We evaluated whether the number of myocardial infarction (MI) 
      segments connected to the papillary muscle (PM), as assessed using cardiac 
      magnetic resonance (CMR) with late gadolinium enhancement (LGE), predicts whether 
      moderate ischemic mitral regurgitation (IMR) improves after isolated coronary 
      artery bypass grafting (CABG) to guide the choice of surgical strategy. METHODS: 
      A total of 54 patients diagnosed with coronary heart disease (CHD) complicated 
      with moderate IMR who underwent isolated CABG were selected continuously in this 
      retrospective study at Beijing Anzhen Hospital. All patients underwent 
      preoperative LGE. The patients were divided into the IMR improved group (37 
      patients) and the unimproved group (17 patients) according to 1-year 
      postoperative echocardiography. The factors associated with no IMR improvement 
      after isolated CABG were analyzed. There was no trial registration and no 
      publication of the study protocol. RESULTS: The number of MI segments connected 
      to PM was an independent risk factor for no IMR improvement after isolated CABG 
      [odds ratio 4.39; 95% confidence interval (CI): 1.93-9.98; P<0.001]. The optimal 
      receiver operating characteristic (ROC) curve cut-off value for no IMR 
      improvement was >/=2 (sensitivity: 82.4%; specificity: 83.8%). Follow-up at 1-5 
      years (median, 2.8 years) showed that the incidences of major adverse 
      cardiovascular and cerebrovascular events (5.4% vs. 23.5%; P=0.041) and New York 
      Heart Association (NYHA) grade (P=0.026) were higher in the unimproved group. 
      CONCLUSIONS: In patients with CHD complicated with moderate IMR, the number of MI 
      segments connected to PM is an independent risk factor for no IMR improvement 
      after isolated CABG. Mitral valve surgery should be performed simultaneously with 
      CABG in patients with >/=2 MI segments connected to the PM.
CI  - 2022 Cardiovascular Diagnosis and Therapy. All rights reserved.
FAU - Zhang, Kui
AU  - Zhang K
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Fu, Wei
AU  - Fu W
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Dai, Qinyi
AU  - Dai Q
AD  - Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, China.
FAU - Zheng, Jubing
AU  - Zheng J
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Biekan, Jumatay
AU  - Biekan J
AD  - Circle Cardiovascular Imaging, Calgary, Alberta, Canada.
FAU - Wang, Yueli
AU  - Wang Y
AD  - Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Yan, Pengyun
AU  - Yan P
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Gu, Xiaoyan
AU  - Gu X
AD  - Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Mu, Junsheng
AU  - Mu J
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Dong, Ran
AU  - Dong R
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Cardiovasc Diagn Ther
JT  - Cardiovascular diagnosis and therapy
JID - 101601613
PMC - PMC9808117
OTO - NOTNLM
OT  - Late gadolinium enhancement (LGE)
OT  - coronary artery bypass grafting (CABG)
OT  - coronary heart disease (CHD)
OT  - moderate ischemic mitral regurgitation (IMR)
OT  - myocardial infarction segments connected to papillary muscle
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://cdt.amegroups.com/article/view/10.21037/cdt-22-301/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2023/01/07 06:00
MHDA- 2023/01/07 06:01
PMCR- 2022/12/01
CRDT- 2023/01/06 02:24
PHST- 2022/06/15 00:00 [received]
PHST- 2022/10/14 00:00 [accepted]
PHST- 2023/01/06 02:24 [entrez]
PHST- 2023/01/07 06:00 [pubmed]
PHST- 2023/01/07 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - cdt-12-06-828 [pii]
AID - 10.21037/cdt-22-301 [doi]
PST - ppublish
SO  - Cardiovasc Diagn Ther. 2022 Dec;12(6):828-839. doi: 10.21037/cdt-22-301.