Myocardial dysfunction associated with valvular heart disease

Frank J. Hildner, Roger P. Javier, Lawrence S. Cohen, Philip Samet, Martin J. Nathan, William Z. Yahr, Jack J. Greenberg

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Seventy-one patients undergoing valve replacement surgery were studied before and after operation to determine change of clinical condition and ventricular contractility. Preoperatively, all patients had functional class III or IV disease (New York Heart Association classification) and 55 percent had myocardial dysfunction. Post-operatively, the condition of 86 percent of patients improved clinically by at least 1 functional class, but 56 percent of patients had myocardial dysfunction. Cardiac index and left ventricular end-diastolic pressures were closely related to changes in angiographically determined myocardial contractility. Neither patient age, sex, duration of cardiopulmonary bypass, residual uncorrected valve disease nor coronary artery disease alone determined the degree of impairment in left ventricular contractility. A high incidence of myocardial dysfunction was found pre- and postoperatively in this study. In 16 patients with pure mitral stenosis, 6 (38 percent) had left ventricular dysfunction preoperatively, demonstrating intrinsic myocardial disease, possibly chronic rheumatic myocarditis. The demonstration of postoperative myocardial contractile abnormalities in previously normal patients suggests an intraoperative cause, perhaps related to cardiopulmonary bypass. Postoperative dysfunction may (1) exist preoperatively and remain unchanged, (2) occur intraoperatively, or (3) exist in a latent form preoperatively but be aggravated by the stress of surgery. Without both pre- and postoperative microscopic examination of the myocardium in the same patient, it is impossible to determine which process is primary.

Original languageEnglish
Pages (from-to)319-326
Number of pages8
JournalThe American journal of cardiology
Volume30
Issue number4
DOIs
StatePublished - Jan 1 1972
Externally publishedYes

Fingerprint

Heart Valve Diseases
Cardiopulmonary Bypass
Mitral Valve Stenosis
Myocarditis
Left Ventricular Dysfunction
Cardiomyopathies
Coronary Artery Disease
Myocardium
Blood Pressure
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hildner, F. J., Javier, R. P., Cohen, L. S., Samet, P., Nathan, M. J., Yahr, W. Z., & Greenberg, J. J. (1972). Myocardial dysfunction associated with valvular heart disease. The American journal of cardiology, 30(4), 319-326. https://doi.org/10.1016/0002-9149(72)90559-0

Myocardial dysfunction associated with valvular heart disease. / Hildner, Frank J.; Javier, Roger P.; Cohen, Lawrence S.; Samet, Philip; Nathan, Martin J.; Yahr, William Z.; Greenberg, Jack J.

In: The American journal of cardiology, Vol. 30, No. 4, 01.01.1972, p. 319-326.

Research output: Contribution to journalArticle

Hildner, FJ, Javier, RP, Cohen, LS, Samet, P, Nathan, MJ, Yahr, WZ & Greenberg, JJ 1972, 'Myocardial dysfunction associated with valvular heart disease', The American journal of cardiology, vol. 30, no. 4, pp. 319-326. https://doi.org/10.1016/0002-9149(72)90559-0
Hildner FJ, Javier RP, Cohen LS, Samet P, Nathan MJ, Yahr WZ et al. Myocardial dysfunction associated with valvular heart disease. The American journal of cardiology. 1972 Jan 1;30(4):319-326. https://doi.org/10.1016/0002-9149(72)90559-0
Hildner, Frank J. ; Javier, Roger P. ; Cohen, Lawrence S. ; Samet, Philip ; Nathan, Martin J. ; Yahr, William Z. ; Greenberg, Jack J. / Myocardial dysfunction associated with valvular heart disease. In: The American journal of cardiology. 1972 ; Vol. 30, No. 4. pp. 319-326.
@article{741668fb165f4ef3b2d8236ed189d26f,
title = "Myocardial dysfunction associated with valvular heart disease",
abstract = "Seventy-one patients undergoing valve replacement surgery were studied before and after operation to determine change of clinical condition and ventricular contractility. Preoperatively, all patients had functional class III or IV disease (New York Heart Association classification) and 55 percent had myocardial dysfunction. Post-operatively, the condition of 86 percent of patients improved clinically by at least 1 functional class, but 56 percent of patients had myocardial dysfunction. Cardiac index and left ventricular end-diastolic pressures were closely related to changes in angiographically determined myocardial contractility. Neither patient age, sex, duration of cardiopulmonary bypass, residual uncorrected valve disease nor coronary artery disease alone determined the degree of impairment in left ventricular contractility. A high incidence of myocardial dysfunction was found pre- and postoperatively in this study. In 16 patients with pure mitral stenosis, 6 (38 percent) had left ventricular dysfunction preoperatively, demonstrating intrinsic myocardial disease, possibly chronic rheumatic myocarditis. The demonstration of postoperative myocardial contractile abnormalities in previously normal patients suggests an intraoperative cause, perhaps related to cardiopulmonary bypass. Postoperative dysfunction may (1) exist preoperatively and remain unchanged, (2) occur intraoperatively, or (3) exist in a latent form preoperatively but be aggravated by the stress of surgery. Without both pre- and postoperative microscopic examination of the myocardium in the same patient, it is impossible to determine which process is primary.",
author = "Hildner, {Frank J.} and Javier, {Roger P.} and Cohen, {Lawrence S.} and Philip Samet and Nathan, {Martin J.} and Yahr, {William Z.} and Greenberg, {Jack J.}",
year = "1972",
month = "1",
day = "1",
doi = "10.1016/0002-9149(72)90559-0",
language = "English",
volume = "30",
pages = "319--326",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Myocardial dysfunction associated with valvular heart disease

AU - Hildner, Frank J.

AU - Javier, Roger P.

AU - Cohen, Lawrence S.

AU - Samet, Philip

AU - Nathan, Martin J.

AU - Yahr, William Z.

AU - Greenberg, Jack J.

PY - 1972/1/1

Y1 - 1972/1/1

N2 - Seventy-one patients undergoing valve replacement surgery were studied before and after operation to determine change of clinical condition and ventricular contractility. Preoperatively, all patients had functional class III or IV disease (New York Heart Association classification) and 55 percent had myocardial dysfunction. Post-operatively, the condition of 86 percent of patients improved clinically by at least 1 functional class, but 56 percent of patients had myocardial dysfunction. Cardiac index and left ventricular end-diastolic pressures were closely related to changes in angiographically determined myocardial contractility. Neither patient age, sex, duration of cardiopulmonary bypass, residual uncorrected valve disease nor coronary artery disease alone determined the degree of impairment in left ventricular contractility. A high incidence of myocardial dysfunction was found pre- and postoperatively in this study. In 16 patients with pure mitral stenosis, 6 (38 percent) had left ventricular dysfunction preoperatively, demonstrating intrinsic myocardial disease, possibly chronic rheumatic myocarditis. The demonstration of postoperative myocardial contractile abnormalities in previously normal patients suggests an intraoperative cause, perhaps related to cardiopulmonary bypass. Postoperative dysfunction may (1) exist preoperatively and remain unchanged, (2) occur intraoperatively, or (3) exist in a latent form preoperatively but be aggravated by the stress of surgery. Without both pre- and postoperative microscopic examination of the myocardium in the same patient, it is impossible to determine which process is primary.

AB - Seventy-one patients undergoing valve replacement surgery were studied before and after operation to determine change of clinical condition and ventricular contractility. Preoperatively, all patients had functional class III or IV disease (New York Heart Association classification) and 55 percent had myocardial dysfunction. Post-operatively, the condition of 86 percent of patients improved clinically by at least 1 functional class, but 56 percent of patients had myocardial dysfunction. Cardiac index and left ventricular end-diastolic pressures were closely related to changes in angiographically determined myocardial contractility. Neither patient age, sex, duration of cardiopulmonary bypass, residual uncorrected valve disease nor coronary artery disease alone determined the degree of impairment in left ventricular contractility. A high incidence of myocardial dysfunction was found pre- and postoperatively in this study. In 16 patients with pure mitral stenosis, 6 (38 percent) had left ventricular dysfunction preoperatively, demonstrating intrinsic myocardial disease, possibly chronic rheumatic myocarditis. The demonstration of postoperative myocardial contractile abnormalities in previously normal patients suggests an intraoperative cause, perhaps related to cardiopulmonary bypass. Postoperative dysfunction may (1) exist preoperatively and remain unchanged, (2) occur intraoperatively, or (3) exist in a latent form preoperatively but be aggravated by the stress of surgery. Without both pre- and postoperative microscopic examination of the myocardium in the same patient, it is impossible to determine which process is primary.

UR - http://www.scopus.com/inward/record.url?scp=0015395321&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0015395321&partnerID=8YFLogxK

U2 - 10.1016/0002-9149(72)90559-0

DO - 10.1016/0002-9149(72)90559-0

M3 - Article

VL - 30

SP - 319

EP - 326

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 4

ER -