Prediction of Symptom Status following Mitral Valve Replacement for Mitral Regurgitation by Preoperative Echocardiographic Measurement of the End-Systolic Stress to End-Systolic Volume Ratio

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Abstract
When determined invasively, the preoperative ratio of left ventricular (LV) end-systolic stress to endsystolic volume index (ESS/ESVi) has correlated well with postmitral valve replacement (MVR) course and LV function, but the predictive power of more practically applicable noninvasive ESS/ESVi measurement has not been assessed. Therefore, we obtained preoperative échocardiographie LV dimensions and simultaneous sphygmomanometric blood pressure for ESS/ESVi determination in 18 patients undergoing MVR for isolated severe chronic mitral regurgitation (MR), and compared results to symptoms and LV function determined by radionuclide cineangiography ejection fraction a mean of 11.8 months postoperatively. Ten of 11 patients with ESS/ESVi > 1.9 had no or mild symptoms (NYHA functional classes 1 and 2 = group I) after operation, while 4/5 patients with preoperative ESS/ESVi 2.6 cm/m2, and the product of ESS/ESVi and LVEF. In addition, preoperative fractional shortening

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