Background: Secondary mitral regurgitation (SMR) has been related to
left ventricular (LV) remodeling and geometric deformation of the mitral
apparatus after myocardial infarction (MI), and proved to be associated with
adverse cardiac events. We assessed the proportion of mild SMR before and after
isolated coronary artery bypass grafting (CABG) surgery, and further study to
evaluate dynamic changes of MR and the determinants of such process on 1 year
follow-up. Methods: From 2019 to 2021, cohort study of 171 consecutive
hospitalized patients who underwent selective isolated CABG surgery were included
and divided into the control group and mild MR group according to whether mild MR
occurred at baseline. Univariate analysis and multivariate logistic regression
analysis were used to test the associations of changes in MR after CABG, and
p 0.05 was considered significant. Results: The mean age of the cohort was 61.31 8.71 years and 78.95% were male at
baseline, divided into the control group (74.85%) and mild MR
group (25.15%), respectively. The LV volumetric and size parameters were higher
in the mild MR group, with decline in LV and left atrial (LA) strain
measurements. About half participants with mild MR at baseline persisted in that
category and the rest reverted to none MR on follow-up, while preoperative left
main coronary artery occlusion may impede the improvement (p 0.05).
The control group at baseline tended to maintain none MR and one-eighth
progressed to mild MR on follow-up, moreover older age and lower LVEF emerged as
key correlation of this development. LA volume index (LAVi) was associated with
an increased risk of developing mild MR (p 0.05).
Conclusions: Patients with secondary mild MR had LA dysfunction and CABG
surgery promoted regression of MR. LAV has an incremental role for early
detection of change in MR over time after surgery.
