Prospective Study Looking at Quality of Life Measures in Non-ischaemic Cardiomyopathy After Mitral Valve Repair
Prospective Study Looking at Quality of Life Measures in Non-ischaemic Cardiomyopathy After Mitral Valve Repair
-  Chronic severe mitral regurgitation can lead to symptoms and left ventricular
 dysfunction.

 -  The purpose of this study is to prospectively follow patients with non-ischaemic
 cardiomyopathy who are eligible for mitral valve repair surgery and primarily measure
 the quality of life through the Minnesota Living with Heart Failure Questionnaire & the
 Kansas City Cardiomyopathy Questionnaire.
-  Chronic mitral regurgitation (MR) usually spirals into a vicious cycle of left
 ventricular (LV) volume overload, LV dilatation, mitral annular dilatation and more MR.
 "MR begets MR". Eventually symptoms and LV dysfunction ensue. However, it can often be
 treated medically or surgically. Medical therapy is primarily afterload reduction and
 diuretics. Surgically, there are two options, either mitral valve repair or replacement.

 -  A number of retrospective studies have demonstrated improved LV function and survival in
 patients undergoing valve repair compared to valve replacement with or without
 subvalvular preservation. In one report, for example, patients who underwent valve
 repair were compared to patients who underwent valve replacement. The report found that
 the former group had lower operative mortality, a greater increase in LV ejection
 fraction and higher overall ten year survival.

 -  The bulk of the literature at present addresses left ventricular dimensions, ejection
 fraction, geometry and New York Heart Association functional class, but few have
 addressed quality of life measures. In addition, most of these studies were
 retrospective and the majority of patients had concomitant ischaemic heart disease.

 -  Even though the studies concerning quality of life after mitral valve surgery have been
 few, nevertheless, some have addressed isolated valve surgery without concomitant bypass
 surgery and have shown improved quality of life, though follow up in some was limited to
 3 months. We will follow our population for 12 months after surgical repair.

 -  We will primarily look at subjective measures for quality of life such as the Minnesota
 Living with Heart Failure Questionnaire & the Kansas City Cardiomyopathy Questionnaire,
 as subjective measures are becoming more and more important following cardiac surgery.
 Patients will serve as their own controls and all study parameters will be compared pre-
 and post surgery.
Inclusion Criteria:

 -  Patients that fulfill surgical criteria set by the 2006 ACC/AHA guidelines for the
 management of patients with valvular heart disease.

 -  Symptomatic mitral regurgitation with left ventricular dysfunction (LVEF < or = 40%)
 on maximal medical therapy

 Exclusion Criteria:

 -  Mitral valve replacement

 -  Concomitant coronary artery bypass surgery

 -  Patient unable to give informed consent