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href="/cardiovascular/specialty.aspx?id=1002">Cardiovascular</a> </li> <li class="tag__item"> <a class="tag__link" href="/cardiovascular/topic.aspx?id=1012">Valvular Heart Disease</a> </li> </ul> </div> <h1 class="content-header__heading" itemprop="name">Left Ventricular-Mitral Valve Ring Ratio May Predict Recurrent Mitral Regurgitation</h1> <div class="content-header__metadata"> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2017-11-20" itemprop="datePublished">Published on November 20, 2017 </time> </p> <p data-module="share-links"> </p> <p class="citation"> Originally published on <cite itemprop="citation"><a href="http://circ.ahajournals.org/content/134/17/1247">Circulation</a></cite> </p> </div> </div> </header> <div class="-padding--vertical -padding--horizontal"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__main"> <div class="layout-columns__main__content"> <div class="content-summary"> <h3 class="content-summary__heading">Key findings</h3> <ul> <li>21% of study patients had recurrent mitral regurgitation at one year after surgery</li> <li>The left ventricular end systolic dimension/ring size ratio predicts recurrent mitral regurgitation</li> <li>The left ventricular end systolic dimension/ring size ratio could be a method for identifying patients at high-risk</li> </ul> </div> <p>With recurrent mitral regurgitation occurring in up to 30% of patients one year after surgery for mitral valve repair and up to 60% after two years, it is critical for clinicians to have a method to decide which patients should receive mitral valve repair or mitral valve replacement. One recent analysis of two randomized clinical trials provides one possibility for that utility.</p><div class="article__signup-container"> <div class="email-signup-inline__container -background--white"> <style> #email-signup-inline { /* 540px */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } @media only screen and (-webkit-min-device-pixel-ratio: 2), only screen and (min--moz-device-pixel-ratio: 2), only screen and (-moz-min-device-pixel-ratio: 2), only screen and (-o-min-device-pixel-ratio: 2/1), only screen and (min-device-pixel-ratio: 2), only screen and (min-resolution: 192dpi), only screen and (min-resolution: 2dppx) { #email-signup-inline { /* 1080 width */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } } </style> <div class="content-container -width--wide -centered email-signup-inline__wrapper" id="email-signup-inline"> <div class="email-signup-inline__logo"> <img alt="Massachusetts General Hospital " src="/assets/logos/logo-white.svg"> </div> </div> <div class="email-signup-inline"> <h3 class="email-signup-inline__heading">Subscribe to the latest updates from Cardiovascular Advances in Motion</h3> <p class="email-signup-inline__subheading"></p>  <meta http-equiv="Content-Type" content="text/html; 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These patients had complete transthoracic echocardiogram one year after ring annuloplasty. Of the 214 patients, 90% underwent coronary artery bypass graft (CABG) along with mitral valve repair surgery.</p> <p>The researchers measured the left ventricular/mitral valve ring discrepancy as the ratio of left ventricular end diastolic dimension and left ventricular end systolic dimension to the implanted ring size. Of the 214 patients, 45 (21%) had moderate to greater mitral regurgitation one year after ring annuloplasty. The patients with recurrent mitral regurgitation weighed less than patients who did not and tended to have lower body surface areas. Also, researchers found that the prevalence of atrial fibrillation, previous CABG and percutaneous coronary intervention was higher in patients with recurrent mitral regurgitation.</p> <p>In univariable analyses, the researchers also found that the left ventricular end systolic dimension and the left ventricular end systolic dimension/ring size ratio significantly predicted one-year recurrence of mitral regurgitation. The odds ratio per 10 mm increase in left ventricular end systolic dimension came to 1.62 (P=0.02) and the odds ratio per 0.5 increase in left ventricular end systolic dimension/ring size ratio came to 2.15 (P=0.007).</p> <p>After adjustment for age, sex, baseline severity of disease and left ventricular ejection fraction, the left ventricular end systolic dimension/ring size ratio still predicted a higher risk of recurrent mitral regurgitation (odds ratio 2.20, P=0.038).</p> <p>The researchers point out that the left ventricular end systolic dimension/ring size ratio could be a utility to identify patients who would be at high risk of recurrent mitral regurgitation after mitral valve ring annuloplasty and guide surgical decision-making as to whether repair or replacement should be performed.</p> <figure class="stat" data-plaintext="21% percentage of study patients who had recurrent mitral regurgitation one year after surgery" data-module="stat"><span class="stat__number"><span data-stat-number="">21</span>%</span> <figcaption class="stat__caption">percentage of study patients who had recurrent mitral regurgitation one year after surgery</figcaption> <p data-module="share-links"></p> </figure><p class="fat-link__wrapper u-text-right"> <a class="fat-link -caret -large" href="http://circ.ahajournals.org/content/134/17/1247">view original journal article <em>Subscription may be required</em></a> </p> <div class="article-attribution" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="article-attribution__logo" itemscope itemtype="http://schema.org/Periodical"> <a href="http://circ.ahajournals.org/content/134/17/1247"> <img alt="" src="/cardiovascular/assets/Circulation.jpg"> <span class="a11y-sr-only" itemprop="name">Circulation</span> </a> </p> <p class="article-attribution__metadata" itemscope itemtype="http://schema.org/PublicationIssue"> <span> Journal Article Published: <time datetime="2016-10-24" itemprop="datePublished">October 24, 2016</time> </span> </p> </div> <p class="cta">Refer a patient to the <a href="https://www.massgeneral.org/heart-center/appointments-and-referrals/referrals">Massachusetts General Hospital Corrigan Minehan Heart Center</a></p> </div> </div> <aside class="layout-columns__sidebar -article__contributors"> <div class="layout-columns__sidebar__content"> <div class="profile-compact__wrapper"> <p class="u-no-margin"> <strong>Contributors</strong> </p> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1048" itemprop="url">Judy Wei-Ming Hung, MD ›</a></h3><p class="profile__title" itemprop="jobTitle">Director of the Echocardiography Lab, Division of Cardiology, Professor of Medicine, Harvard Medical School</p> </div> <p class="profile__image"> <img alt="Judy Wei-Ming Hung, MD" itemprop="image" srcset="/assets/images/contributors/Hung_Judy_advances.png, /assets/images/contributors/Hung_Judy_advances_2x.png 2x" src="/assets/images/contributors/Hung_Judy_advances.png"> </p> </div> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1047" itemprop="url">Robert A. Levine, MD ›</a></h3><p class="profile__title" itemprop="jobTitle">Senior Physician, Cardiac Ultrasound Laboratory</p> </div> </div> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1028" itemprop="url">Serguei Melnitchouk, MD, MPH ›</a></h3><p class="profile__title" itemprop="jobTitle">Cardiac Surgeon, Co-Director, Heart Valve Program, Quality Director, Division of Cardiac Surgery</p> </div> <p class="profile__image"> <img alt="Serguei Melnitchouk, MD" itemprop="image" srcset="/assets/images/contributors/Melnitchouk_Serguei_19342_advances.png, /assets/images/contributors/Melnitchouk_Serguei_19342_advances_2x.png 2x" src="/assets/images/contributors/Melnitchouk_Serguei_19342_advances.png"> </p> </div> </div> </div> </aside> <section class="topics-layout -article__related"> <div class="topics-layout__inner"> <div class="topics-layout__sidebar"> <h2 class="section-heading">Related topics</h2> </div> <div class="topics-layout__main"> <ul class="topics-list" data-module="topics-list"> <li><a href="/cardiovascular/topic.aspx?id=1036">Cardiac Surgery</a></li> <li><a href="/cardiovascular/topic.aspx?id=1012">Valvular Heart Disease</a></li> </ul> </div> </div> </section> <section class="-padding--horizontal -padding--vertical -article__related"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/cardiovascular/article.aspx?id=1004" itemprop="url">Paradigm Shift in Mitral Valve Repair Management and Treatment</a> </h3> <p itemprop="description"> <p>Chronic severe MR patients are without intervention until symptoms appear. 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Particularly Among Those in AF</a> </h3> <p itemprop="description"> <p>A meta-analysis by Mass General Hospital researchers addresses growing interest in LAAC performed as a prophylactic surgical procedure concomitant with other cardiac surgical procedures.</p></p> <p class="content-tease__related"> <a href="/cardiovascular/topic.aspx?id=1036" itemprop="relatedLink">Cardiac Surgery</a>, <a href="/cardiovascular/specialty.aspx?id=1002" itemprop="relatedLink">Cardiovascular</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2018-08-28" itemprop="datePublished">August 28, 2018</time> </p> </div> </div> </div> </section> </div> </div> </article> </div> </main>  <footer class="site-footer"> <div class="-padding--horizontal"> <nav aria-label="Footer links" class="content-container -width--wide -centered -padding--bottom"> <ul class="footer__nav" role="presentation"> <li> <a 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