The results from the analysis of the preoperative cardiac status and postoperative period of 140 patients with ischemic heart disease and significant ischemic mitral regurgitation (IMR) were presented. In 71 patients, surgical revascularization and simultaneous mitral valve repair was done (group A). The rest 69 patients were subjected to isolated coronary artery bypass procedure (group B). Control transthoracic echocardiographic examinations were performed before discharge from hospital and postoperative follow-up (mean 20 months) was accomplished. The emphasis was made on the left atrial morphology prior to the intervention as well as on the gradual changes following the two types of procedures. It is established that immediately after isolated revascularization, left atrial size decreases, but slightly and temporarily. Later on, dilatation goes on and at patient`s follow-up its mean size is bigger than preoperatively. On the other hand, combined coronary revascularization and mitral valve repair result in more prominent and durable left atrial reduction. Based on this a conclusion can be drawn that combined surgical revascularization and mitral repair may trigger a process of significant left atrial reverse remodeling thus lowering the risk of subsequent cardiovascular accidents.
Петровски, П. Оптимизация на междувентрикулар- ното закъснение (V-V timing) ри пациенти, подложени на сърдечна ресинхронизираща терапия (СРТ) с използване на 3-размерна ехокардиография и избор между 4 пейсиращи режима. Воен. мед., 2009;51(3):10- 13.
Benjamin, E. J., R. B. D’Agostino, A. J. Belanger, P.
A. Wolf, D. Levy. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation, 1995;92(4):835-841.
Casaclang-Verzosa, G., B. J. Gersh, T. S. Tsang. Struc- tural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillation. J. Am. Coll. Cardiol., 2008;51(1):1-11.
Nattel, S., B. Burstein, D. Dobrev. Atrial remodeling and atrial fibrillation: mechanisms and implications. Circ. Arrhythm. Electrophysiol., 2008;1(1):62-73.
Psaty, B. M., T. A. Manolio, L. H. Kuller, R. A. Kro- nmal, M. Cushman, L. P. Fried, R. White, C. D. Furberg,
P. M. Rautaharju. Incidence of and risk factors for atrial fibrillation in older adults. Circulation, 1997;96,(7):2455- 2461.
Vaziri, S. M., M. G. Larson, E. J. Benjamin, D. Levy. Echocardiographic predictors of nonrheumatic atrial fi- brillation. The Framingham Heart Study. Circulation, 1994;89(2):724-730.
Westenberg, J. J., R. J. van der Geest, H. J. Lamb, M.
I. Versteegh, J. Braun, J. Doornbos, A. de Roos, E. E. van der Wall, R. A. Dion, J. H. Reiber, J. J. Bax. MRI to evalu- ate left atrial and ventricular reverse remodeling after re- strictive mitral annuloplasty in dilated cardiomyopathy.- Circulation, 2005;112(9, Suppl.):I437-I442.
