Effect of cardiac resynchronization therapy on mitral valve geometry: a novel aspect as 'reversed mitral remodeling'
| Autor: | Irfan Barutcu, Bilal Boztosun, Beytullah Çakal, Mehmet Onur Omaygenç, Filiz Kızılırmak, Oguz Karaca, Fethi Kilicaslan, Hacı Murat Güneş, Deniz Dilan Naki, Sinem Çakal |
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| Přispěvatelé: | Karaca, Oguz, Cakal, Beytullah, Omaygenc, Mehmet Onur, Gunes, Haci Murat, Kizilirmak, Filiz, Cakal, Sinem Deniz, Naki, Deniz Dilan, Barutcu, Irfan, Boztosun, Bilal Medipol Univ, Dept Cardiol, Fac Med, Tem Otoyolu Goztepe Cikisi 1, TR-34214 Istanbul, Turkey, Kilicaslan, Fethi Medipol Univ, Cardiac Electrophysiol Dept, Fac Med, Istanbul, Turkey |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_treatment Cardiac resynchronization therapy Regurgitant volume Geometry 030204 cardiovascular system & hematology Cardiac Resynchronization Therapy 03 medical and health sciences 0302 clinical medicine Mitral valve medicine Humans Radiology Nuclear Medicine and imaging In patient 030212 general & internal medicine Tenting Area Cardiac imaging Mitral Regurgitation Aged Retrospective Studies Reverse Remodeling Heart Failure Mitral regurgitation Ventricular Remodeling business.industry Incidence (epidemiology) Mitral Valve Insufficiency Middle Aged medicine.anatomical_structure Echocardiography Etiology Mitral Valve Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The international journal of cardiovascular imaging. 34(7) |
| ISSN: | 1875-8312 |
| Popis: | WOS: 000438113200005 PubMed ID: 29387972 Amelioration of the valvular geometry is a possible mechanism for mitral regurgitation (MR) improvement in patients receiving cardiac resynchronization therapy (CRT). We aimed to establish the precise definition, incidence, and predictors of reversed mitral remodeling (RMR), as well as the association with MR improvement and short-term CRT outcome. Ninety-five CRT recipients were retrospectively evaluated for the end-point of "MR response" defined as the absolute reduction in regurgitant volume (RegV) at 6 months. To identify RMR, changes in mitral deformation indices were tested for correlation with MR response and further analyzed for functional and echocardiographic CRT outcomes. Overall, MR response was observed in 50 patients (53%). Among the echocardiographic indices, the change in tenting area (TA) had the highest correlation with the change in RegV (r = 0.653, p < 0.001). The mean TA significantly decreased in MR responders (4.15 +/- 1.05 to 3.67 +/- 1.01 cm(2) at 6 months, p < 0.001) and increased in non-responders (3.68 +/- 1.04 to 3.98 +/- 0.97 cm(2), p = 0.014). The absolute TA reduction was used to identify patients with RMR (47%) which was found to be associated with higher rates of functional improvement (p = 0.03) and volumetric CRT response (p = 0.036) compared to those without RMR. Non-ischemic etiology and the presence of LBBB independently predicted RMR at multivariate analysis. In conclusion, reduction in TA is a reliable index of RMR, which relates to MR response, and functional and echocardiographic improvement with CRT. LBBB and non-ischemic etiology are independent predictors of RMR. |
| Databáze: | OpenAIRE |
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