A Nomogram to Predict the Improvement of Moderate Ischemic Mitral Regurgitation after Coronary Artery Bypass Grafting
Presented During:
Friday, May 5, 2023: 8:00AM - 8:05AM
New York Hilton Midtown
Posted Room Name:
Petit Trianon
Abstract No:
MO068
Submission Type:
Abstract Submission
Authors:
Xiaotian Sun (1), Yiqing Wang (1)
Institutions:
(1) Huashan Hospital Fudan University, Shanghai, Shanghai
Submitting Author:
Xiaotian Sun
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Huashan Hospital Fudan University
Huashan Hospital Fudan University
Co-Author:
Yiqing Wang
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Huashan Hospital Fudan University
Huashan Hospital Fudan University
Presenting Author:
Xiaotian Sun
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Huashan Hospital Fudan University
Huashan Hospital Fudan University
Abstract:
OBJECTIVE: To develop a nomogram to predict improvement in moderate ischemic mitral regurgitation (IMR) after coronary artery bypass grafting (CABG).
METHODS: Data were retrospectively collected from 112 patients with prior myocardial infarction and moderate IMR undergoing CABG. Patients were divided into two groups based on IMR degree 1 year after CABG as follows: Improved Group with no or mild IMR (n = 54) and Failure Group with moderate or severe IMR (n = 58). To determine the predictors of postoperative IMR improvement, preoperative clinical and echocardiographic data were compared, and a nomogram was formulated based on all independent predictors. Discriminative ability, calibration, and clinical usefulness of the prediction model were assessed.
RESULTS: Independent predictors of IMR improvement after CABG constructing the nomogram included duration between infarction and operation, posterior-inferior regional volume ratio to left ventricular (LV) volume, LV dyssynchrony index Tmsv_16_dif, P3 leaflet tethering angle, and annular Non-planar angle. The nomogram exhibited well-fitted calibration curves and excellent discriminative ability. The area under receiver operating characteristic curve was 0.974. Patients with a score > 236 demonstrated a high probability of IMR improvement (sensitivity, 90.7%; specificity, 93.1%). Patients in the Improved Group demonstrated significantly greater actuarial survival rates than those in the Failure Group.
CONCLUSIONS: The nomogram combining 5 preoperative clinical and echocardiographic predictors provides an accurate preoperative estimation of moderate IMR improvement after surgery, with excellent discriminative ability. Based on this nomogram, patients with a higher score predict a higher probability of IMR improvement.
METHODS: Data were retrospectively collected from 112 patients with prior myocardial infarction and moderate IMR undergoing CABG. Patients were divided into two groups based on IMR degree 1 year after CABG as follows: Improved Group with no or mild IMR (n = 54) and Failure Group with moderate or severe IMR (n = 58). To determine the predictors of postoperative IMR improvement, preoperative clinical and echocardiographic data were compared, and a nomogram was formulated based on all independent predictors. Discriminative ability, calibration, and clinical usefulness of the prediction model were assessed.
RESULTS: Independent predictors of IMR improvement after CABG constructing the nomogram included duration between infarction and operation, posterior-inferior regional volume ratio to left ventricular (LV) volume, LV dyssynchrony index Tmsv_16_dif, P3 leaflet tethering angle, and annular Non-planar angle. The nomogram exhibited well-fitted calibration curves and excellent discriminative ability. The area under receiver operating characteristic curve was 0.974. Patients with a score > 236 demonstrated a high probability of IMR improvement (sensitivity, 90.7%; specificity, 93.1%). Patients in the Improved Group demonstrated significantly greater actuarial survival rates than those in the Failure Group.
CONCLUSIONS: The nomogram combining 5 preoperative clinical and echocardiographic predictors provides an accurate preoperative estimation of moderate IMR improvement after surgery, with excellent discriminative ability. Based on this nomogram, patients with a higher score predict a higher probability of IMR improvement.
Mitral Conclave:
Ischemic Mitral Regurgitation
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