Investigation into the Early Modification of Left Ventricular Mass Following Mitral Valve Replacement and the Development of a Nomogram Prediction Model

Wu SZ Xia L, Wei T, Niu TY and Zhu Y

Jinzhou Medical University, China General Hospital of Northern Theater Command, China Dalian Medical University, China

^*Correspondance to: Yan Zhu 

 PDF  Full Text DOI: 10.25107/2474-1647.3695

Abstract

Background: Mitral valve disease caused by rheumatic heart disease and mitral valve disease caused by degenerative valvular disease are common types of mitral valve disease. Mitral Valve Replacement surgery (MVR) is an effective treatment for mitral regurgitation. This study observed the changes of Left Ventricular Mass (LVM) and other indicators through mitral valve lesions caused by different types of lesions, and further observed the changes of left ventricular mass and other indicators after MVR. The effects of preoperative LVM and other indicators on postoperative ejection fraction reduction in patients with MVR were described, and the model was established as a risk factor. Method: A retrospective study was conducted on the baseline data and perioperative echocardiographic data obtained during hospitalization of 80 patients with rheumatic or degenerative mitral valve disease from September 2022 to March 2023. The patients were divided into two groups, group A and Group B, according to the relevant perioperative indicators obtained by the formula of LVM, Left Ventricular Mass Index (LVMI) and Relative Ventricular Wall Thickness (RWT). Group A (rheumatic heart disease, n=50) and group B (degenerative valvular disease, n=30). The changes of left ventricle in two groups were observed. Then, the risk factors affecting the reduction of Ejection Fraction (EF) 3 months after surgery were screened by univariate and multivariate Logistic regression analysis, and the corresponding risk prediction model was established by using RStudio, and the model was evaluated and verified. Results: The preoperative LVM, LVMI, left ventricular volume and left ventricular size in group A were lower than those in group B, and the differences were statistically significant (P<0.05), and there was no significant change in RWT between the two groups (P>0.05); The LVM, LVMI, left ventricular volume and left ventricular size of the whole patients at 1 week and 1 month after surgery were all regression compared with those before surgery, and the differences were statistically significant (P<0.05); There were no significant changes in LVM, left ventricular volume and left ventricular size 3 months after surgery compared with 1 month after surgery (P>0.05). Logistic regression analysis showed that left anterior and posterior atrial diameter (OR=1.399, 95% CI: 0.978~2.002) and left ventricular end-diastolic diameter (OR=1.269, 95% CI: 1.034~1.558), LVM (OR=1.129, 95% CI: 1.042~1.223) and serum creatinine (OR=1.114, 95% CI: 1.028~1.207) were independent risk factors for postoperative EF decline (P<0.05). A prediction model was established based on the risk factors, and the model was validated and evaluated. Based on this model, a column graph was established to observe the influence of each risk factor on the results.

Keywords

Left ventricular mass; Left ventricular mass index; Rheumatic valvular disease; Degenerative valvular disease; Mitral valve replacement surgery; Nomograph

Cite the article

Wu SZ, Xia L, Wei T, Niu TY, Zhu Y. Investigation into the Early Modification of Left Ventricular Mass Following Mitral Valve Replacement and the Development of a Nomogram Prediction Model. Clin Surg. 2024; 9: 3695..