Comprehensive Assessment of Ventricular Remodeling Following Mitral Valve Repair: A Focus on Volume, Mass, and Relative Wall Thickness.

Background: Mitral valve repair facilitates ventricular reverse remodeling, inducing changes in geometry and mass. This study examined geometric normalization and mass regression following valve repair, and evaluated correlations between recurrent mitral regurgitation (MR) and long-term clinical outcomes. Methods: This study included 160 consecutive patients undergoing mitral valve repair, stratified according to the severity of recurrent MR. Serial Doppler echocardiographic parameters including ventricular geometry and hemodynamic indices were compared between baseline and post-repair assessments. Cox regression analysis was conducted to identify the predictors associated with recurrent MR and late adverse events. Results: During follow-up, MR < grade 3 was noted in 107 patients and MR ≥ grade 3 in 53 patients. The entire cohort experienced 43 major adverse cardiovascular and cerebral events (MACCEs). Paired comparisons demonstrated consistent reductions in dimension, intracavity volume, ventricular mass, stroke volume, and wall stress (WS), accompanied by increases in relative wall thickness (RWT) in both subgroups. However, the MR ≥ grade 3 subgroup demonstrated attenuated reverse remodeling. Both left ventricle (LV) WS and mass showed positive correlations with dimension and volume, but WS was inversely correlated with RWT. Suture annuloplasty was more prevalent in the MR ≥ grade 3 subgroup. The results of Cox regression analysis identified regurgitant volume, end-systolic volume, LV mass, and suture annuloplasty as independent predictors of MACCEs. Conclusions: The extent of reverse remodeling was correlated with the reduction in regurgitant volume. Suture annuloplasty was a predictor for recurrent MR. The persistence of volume overload and eccentric hypertrophy impacted late clinical outcomes.