MO68. A Nomogram to Predict the Improvement of Moderate Ischemic Mitral Regurgitation after Coronary Artery Bypass Grafting
Presented During: Mini-Orals: Translational Research, Innovation, Predictive Modeling
Huashan Hospital Fudan University
Shanghai, Shanghai
China - Contact Me
Xiaotian Sun Ph.D., M.D. is the associate proffesor in Huashan Hospital Fudan University (Shanghai, CN). Prof. Sun worked as the cardiac surgeon for 15 years, and has been known as the famous specilist in mitral valve and CABG surgeries. He also did a lot of research work in the field of heart disease, especially in the treatment of ischemic mitral regurgitation. He had many excellent work in this field, which were published in JTCVS, ATS, as well as EJCTS journals. Prof. Sun also had many basic research work in valve disease and ischemic heart disease.
Friday, May 5, 2023: 8:00 AM - 8:05 AM
5 Minutes
New York Hilton Midtown
Room: Petit Trianon
Description
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.
Presentation Duration
3-minute presentation; 2-minute discussion