Changes of Left Ventricular Morphology and Contractile Function of Patients with Mitral Stenosis and Small Left Ventricle after Mitral Valve Replacement: A Systematic Review and Meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

QIAOWei-hua , LIUPeng , SHIJia-wei , WANGYin ,  DONGNian-guo

Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, P.R.China;

Corresponding?author：

DONGNian-guo, Email: dongnianguo@hotmail.com

Keywords：

Mitral stenosis; Small left ventricle; Mitral valve replacement; Therapeutic effect; Systematic review/meta-analysis

DOI：

10.7507/1007-4848.20160141

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the changes of left ventricular morphology and contractile function of patients with mitral stenosis and small left ventricle after mitral valve replacement. Methods Studies on the changes of left ventricular morphology and contractile function of patients with mitral stenosis and small left ventricle after mitral valve replacement were searched from the databases of Wangfang, VIP, CNKI, PubMed, Elsevier Science Direct, and Cochrane Library from establishment to January 2015. Quality of articles was evaluated. Relevant data were extracted from eligible studies to conduct meta-analysis. Mean differences (MD) of left ventricle end-diastolic volume index (LVEDVI), left ventricle end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) between the preoperative and the postoperative value from eligible studies were analyzed and pooled, and their 95% confidence intervals (CI) were calculated. R2.15.3 software was applied for statistical analysis. Results Eight eligible studies involving 446 patients were analyzed in the study. The quality of included literature was high. The results of meta-analysis showed that LVEDVI and LVEDD increased by 14.51 ml/m² with 95%CI -22.78 to -6.25 (P<0.01) and 4.88 mm with 95%CI -10.85 to 1.09 (P=0.11) respectively at 2 weeks postoperatively compared with preoperative value. LVEF decreased by 3.05% with 95%CI -3.02% to 9.12% (P=0.32) while LVFS increased by 1.16% with 95%CI -4.83% to 2.50% (P=0.53) at 2 weeks postoperatively. Compared with preoperative value, LVEDVI and LVEDD markedly increased by 16.11 ml/m² with 95%CI -20.32 to -11.90 (P<0.01) and 10.56 mm with 95%CI -11.52 to -9.60 (P<0.01) respectively at 6 months postoperatively. LVEF and LVFS increased by 7.69% with 95%CI -17.18% to 1.8% (P=0.11) and 6.21% with 95%CI -10.07% to -2.36% (P<0.01) respectively at 6 months postoperatively compared with preoperative value. Conclusion Left ventricular morphology and contractile function of patients with mitral stenosis and small left ventricle recovers well after mitral valve replacement.

Citation： QIAOWei-hua, LIUPeng, SHIJia-wei, WANGYin, DONGNian-guo. Changes of Left Ventricular Morphology and Contractile Function of Patients with Mitral Stenosis and Small Left Ventricle after Mitral Valve Replacement: A Systematic Review and Meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(6): 589-594. doi: 10.7507/1007-4848.20160141 Copy

1.	孫益峰, 王永武. 重癥心臟瓣膜病的治療進展. 同濟大學學報(醫學版), 2001, 22(2):33.
2.	張寶仁, 朱家麟, 主編. 人造心臟瓣膜與瓣膜置換術. 第2版. 北京:人民衛生出版社, 1999. 291-292.
3.	王寅, 董念國, 史嘉瑋, 等. 大左心室心臟瓣膜病術后左心室形態及收縮功能變化的系統評價. 中國胸心血管外科臨床雜志, 2013, 20(2):125-134.
4.	Wells G, Shea B, Connell D, et al. The Newcastle Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis.[2008-12-26]. http://www.ohri.ca/programs/clinical_epidemiology/oxford_web.ppt.July12,2006.
5.	徐志云, 張寶仁, 朱家麟, 等. 風心病二尖瓣狹窄合并小左心室的瓣膜替換術. 中華胸心血管外科雜志, 1997, 13(1):1-4.
6.	熊衛民, 龍建平, 盛斌, 等. 重度二尖瓣狹窄伴小左心室的外科治療. 醫學臨床研究, 2004, 21(11):1295-1296.
7.	滕和志, 王向麗, 秦春新, 等. 36 例小左心室患者二尖瓣置換治療體會. 中國醫藥, 2006, 1(4):232-233.
8.	華菲, 沈振亞, 肖接承, 等. 重度二尖瓣狹窄伴小左心室 28 例圍手術期觀察. 中國現代醫藥雜志, 2006, 8(12):47-49.
9.	張旭光, 陳智豫, 郝曉斌. 重度二尖瓣狹窄伴薄小左心室的外科治療. 昆明醫學院學報, 2008, 29(6):102-104.
10.	姜勝利, 高長青, 李伯君, 等. 小左心室患者瓣膜置換術后早期心臟形態及功能的變化. 中華外科雜志, 2009, 47(12):924-926.
11.	許詠冬, 章響艷, 涂韶松, 等. 小左心室患者二尖瓣手術綜合策略. 浙江醫學, 2010, 32(5):711-713.
12.	黃壯榮, 章海波, 馬慶榮, 等. 體外膜肺氧合輔助外科治療合并小左心室瓣膜病 13 例. 廣東醫學, 2010, 31(9):1171-1173.
13.	Carapetis JR, Steer AC, Mulholland EK, et al. The global burden of group A streptococcal diseases. Lancet Infect Dis, 2005, 5(11):685-694.
14.	白一帆, 主編. 成人心臟瓣膜病外科治療20年回顧及危險因素變遷. 上海:第二軍醫大學. 2012. 1-6.
15.	Chandrashekhar Y, Westaby S, Narula J. Mitral stenosis. Lancet, 2009, 374:1271-1283.
16.	王云, 萬榮華, 劉霞. 風濕性二尖瓣狹窄對左心室舒張末容量的影響. 西安交通大學學報:醫學版, 2006, 27(3):309.
17.	馬增山, 馬勝軍, 董銘峰, 等. 小左心室患者心瓣膜置換術的圍手術期處理. 中國胸心血管外科臨床雜志, 2005, 12(3):225-225.
18.	周旭毓, 夏旭. 醫學信息定量綜合的新方法-Meta 分析. 醫學信息, 2002, 15(5):303-305.
19.	Gash AK, Carabello BA, Cepin D, et al. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation, 1983, 67(1):148-154.
20.	Gaasch WH, Folland ED. Left ventricular function in rheumatic mitral stenosis. Euro heart j, 1991, 12(suppl B):66-69.
21.	馬沛然, 楊亞超, 韓秀珍, 等. 左室射血分數和左室小軸縮短率對判斷左心功能的價值. 山東醫藥, 1984, 11:012.
22.	隋東虎, 劉治全. 風濕性心臟病左心室心肌病理改變與術后心功能的關系. 中國循環雜志, 1999, 14(4):233-235.

1. 孫益峰, 王永武. 重癥心臟瓣膜病的治療進展. 同濟大學學報(醫學版), 2001, 22(2):33.
2. 張寶仁, 朱家麟, 主編. 人造心臟瓣膜與瓣膜置換術. 第2版. 北京:人民衛生出版社, 1999. 291-292.
3. 王寅, 董念國, 史嘉瑋, 等. 大左心室心臟瓣膜病術后左心室形態及收縮功能變化的系統評價. 中國胸心血管外科臨床雜志, 2013, 20(2):125-134.
4. Wells G, Shea B, Connell D, et al. The Newcastle Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis.[2008-12-26]. http://www.ohri.ca/programs/clinical_epidemiology/oxford_web.ppt.July12,2006.
5. 徐志云, 張寶仁, 朱家麟, 等. 風心病二尖瓣狹窄合并小左心室的瓣膜替換術. 中華胸心血管外科雜志, 1997, 13(1):1-4.
6. 熊衛民, 龍建平, 盛斌, 等. 重度二尖瓣狹窄伴小左心室的外科治療. 醫學臨床研究, 2004, 21(11):1295-1296.
7. 滕和志, 王向麗, 秦春新, 等. 36 例小左心室患者二尖瓣置換治療體會. 中國醫藥, 2006, 1(4):232-233.
8. 華菲, 沈振亞, 肖接承, 等. 重度二尖瓣狹窄伴小左心室 28 例圍手術期觀察. 中國現代醫藥雜志, 2006, 8(12):47-49.
9. 張旭光, 陳智豫, 郝曉斌. 重度二尖瓣狹窄伴薄小左心室的外科治療. 昆明醫學院學報, 2008, 29(6):102-104.
10. 姜勝利, 高長青, 李伯君, 等. 小左心室患者瓣膜置換術后早期心臟形態及功能的變化. 中華外科雜志, 2009, 47(12):924-926.
11. 許詠冬, 章響艷, 涂韶松, 等. 小左心室患者二尖瓣手術綜合策略. 浙江醫學, 2010, 32(5):711-713.
12. 黃壯榮, 章海波, 馬慶榮, 等. 體外膜肺氧合輔助外科治療合并小左心室瓣膜病 13 例. 廣東醫學, 2010, 31(9):1171-1173.
13. Carapetis JR, Steer AC, Mulholland EK, et al. The global burden of group A streptococcal diseases. Lancet Infect Dis, 2005, 5(11):685-694.
14. 白一帆, 主編. 成人心臟瓣膜病外科治療20年回顧及危險因素變遷. 上海:第二軍醫大學. 2012. 1-6.
15. Chandrashekhar Y, Westaby S, Narula J. Mitral stenosis. Lancet, 2009, 374:1271-1283.
16. 王云, 萬榮華, 劉霞. 風濕性二尖瓣狹窄對左心室舒張末容量的影響. 西安交通大學學報:醫學版, 2006, 27(3):309.
17. 馬增山, 馬勝軍, 董銘峰, 等. 小左心室患者心瓣膜置換術的圍手術期處理. 中國胸心血管外科臨床雜志, 2005, 12(3):225-225.
18. 周旭毓, 夏旭. 醫學信息定量綜合的新方法-Meta 分析. 醫學信息, 2002, 15(5):303-305.
19. Gash AK, Carabello BA, Cepin D, et al. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation, 1983, 67(1):148-154.
20. Gaasch WH, Folland ED. Left ventricular function in rheumatic mitral stenosis. Euro heart j, 1991, 12(suppl B):66-69.
21. 馬沛然, 楊亞超, 韓秀珍, 等. 左室射血分數和左室小軸縮短率對判斷左心功能的價值. 山東醫藥, 1984, 11:012.
22. 隋東虎, 劉治全. 風濕性心臟病左心室心肌病理改變與術后心功能的關系. 中國循環雜志, 1999, 14(4):233-235.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Changes of Left Ventricular Morphology and Contractile Function of Patients with Mitral Stenosis and Small Left Ventricle after Mitral Valve Replacement: A Systematic Review and Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content