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126). Another 17% (6/36) of the patients demonstrated a reduction in LAVi not reaching the cut-off of Quinapyramine months after surgery (p=0.790). The left ventricular end-diastolic dimension decreased to 52��4 mm (p MS-275 solubility dmso The preoperative left ventricular end-systolic dimension was 38��8 mm in those with severe preoperative LA enlargement and 37��7 mm in those without, p=0.444. The left ventricular end-systolic dimension was significantly higher in those with severe preoperative LA enlargement than in those without 6 months postoperatively (37��9 mm and 31��9 mm, respectively, p=0.045). Three patients with severe preoperative LA enlargement and one patient without had moderate MR at the 6-month echocardiographic follow-up. Discussion In the current study, patients with severe preoperative LA enlargement had significantly higher baseline mean PCWP and NT-proBNP levels than those without severe preoperative LA enlargement. The mean PCWP was reduced to normal levels in patients with severe preoperative LA enlargement early after MVS, while the mean PCWP remained normal in patients without severe preoperative LA enlargement. The overall incidence of postoperative LARR was 75% six months after surgery, with no significant difference between the groups. The left GDC-0449 ventricular end-diastolic dimension and LVEF decreased postoperatively, and no significant difference was seen between patients with and without severe preoperative LA enlargement. The NT-proBNP levels increased initially during the early postoperative period, but had decreased significantly six months after surgery in both groups. LA enlargement in patients with conservatively managed MR has previously been described as a predictor of stroke, atrial fibrillation, systo-diastolic ventricular failure, and impaired survival [9, 15]. However, those undergoing MVS demonstrate a high potential for left sided reverse remodeling [6] with the same risk of postoperative complications of patients without LARR [10]. The predisposing mechanism for this process is not fully understood. Measurement of PCWP has been established as a surrogate for estimation of the left ventricular end-diastolic pressure [16], but also as an accurate method of assessing LA pressure in patients with MR [17].