期刊
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
卷 19, 期 2, 页码 208-215出版社
OXFORD UNIV PRESS
DOI: 10.1093/ehjci/jex011
关键词
secondary mitral regurgitation; dilated cardiomyopathy; mitraclip; surgical mitral valve repair; speckle tracking echocardiography
资金
- European Society of Cardiology training grant
- European Association of Cardiovascular Imaging research grant
- European Heart House, Sophia-Antipolis, France
- Hellenic Society of Cardiology training grant
- Hellenic Foundation of Cardiology research grant, Athens, Greece
- Biotronik
- Medtronic
- Boston Scientific Corporation
- Abbott Vascular
Aims It remains unclear whether surgical or transcatheter mitral valve repair for secondary mitral regurgitation (MR) in patients with non-ischaemic cardiomyopathy reverse the underlying left ventricular (LV) pathophysiology. We hypothesized that mitral valve repair improves LV systolic function and forward flow and induces LV reverse remodelling in this group of patients. Methods and results Seventy-six patients (65 +/- 14 years old, 43% male) with non-ischaemic cardiomyopathy and moderate to severe chronic secondary MR treated successfully with transcatheter or surgical mitral valve repair were evaluated. Transthoracic echocardiography was performed at baseline, discharge and 6 months post-repair. After mitral valve repair, LVEF, and LV global longitudinal strain (GLS) corrected for LV end-diastolic volume remained unchanged over time (P = 0.90 and P = 0.96, respectively). In contrast, LV forward flow increased significantly over time (stroke volume index: from 20 +/- 7 to 29 +/- 8 and 26 +/- 8 mL/m(2), P < 0.001; cardiac index: from 1.50 +/- 0.44 to 2.36 +/- 0.60 and 2.01 +/- 0.48 L/min/m(2), P < 0.001). In addition, LV end-diastolic and end-systolic volume index significantly reduced over time (from 87 +/- 42 to 70 +/- 33 and 75 +/- 39 mL/m(2), P < 0.001; and from 60 +/- 35 to 50 +/- 30 and 53 +/- 36 mL/m(2), P = 0.004, respectively). These changes were independent of the type of repair. Conclusion Surgical and transcatheter mitral valve repair for secondary MR in patients with non-ischaemic dilated cardiomyopathy improved LV forward flow and induced LV reverse remodelling but did not change LV systolic function.
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