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Nomogram Predicts Improvement of Ischemic Mitral Regurgitation After Coronary Artery Bypass Grafting
- Source :
- The Annals of Thoracic Surgery. 114:1656-1663
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- BACKGROUND Developing a nomogram to predict improvement in moderate ischemic mitral regurgitation (IMR) after coronary artery bypass grafting (CABG) is in need. METHODS Between 2010 and 2018, 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, poster-inferior to left ventricular volume ratio, maximum difference of the time to reach minimum systolic volume of 16 segments, 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 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 higher probabilities of IMR improvement.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.medical_treatment
Myocardial Ischemia
Infarction
Internal medicine
medicine
Humans
Myocardial infarction
Coronary Artery Bypass
End-systolic volume
Retrospective Studies
Mitral valve repair
Receiver operating characteristic
Ischemic mitral regurgitation
business.industry
Mitral Valve Insufficiency
Nomogram
medicine.disease
Nomograms
Treatment Outcome
medicine.anatomical_structure
Cardiology
Surgery
Cardiology and Cardiovascular Medicine
business
Artery
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 114
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....ecfebb853e449056ebc08e4af6451523