Percutaneous mitral valve repair in the initial EVEREST cohort: evidence of reverse left ventricular remodeling.

MedStar author(s):
Citation: Circulation. Cardiovascular imaging. 6(4):522-30, 2013 Jul.PMID: 23633132Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Clinical Trial, Phase II | Journal Article | Multicenter Study | Randomized Controlled Trial | Research Support, Non-U.S. Gov'tSubject headings: *Cardiac Catheterization | *Heart Ventricles/pp [Physiopathology] | *Mitral Valve Annuloplasty | *Mitral Valve Insufficiency/th [Therapy] | *Ventricular Dysfunction, Left/pp [Physiopathology] | *Ventricular Function, Left | *Ventricular Remodeling | Aged | Aged, 80 and over | Analysis of Variance | Canada | Cardiac Catheterization/is [Instrumentation] | Cardiac Catheters | Equipment Design | Female | Heart Ventricles/us [Ultrasonography] | Hemodynamics | Humans | Male | Middle Aged | Mitral Valve Annuloplasty/is [Instrumentation] | Mitral Valve Insufficiency/pp [Physiopathology] | Mitral Valve Insufficiency/us [Ultrasonography] | Prospective Studies | Recovery of Function | Severity of Illness Index | Stroke Volume | Time Factors | Treatment Outcome | United States | Ventricular Dysfunction, Left/us [Ultrasonography]Year: 2013ISSN:
  • 1941-9651
Name of journal: Circulation. Cardiovascular imagingAbstract: BACKGROUND: Percutaneous repair of mitral regurgitation (MR) permits examination of the effect of MR reduction without surgery and cardiopulmonary bypass on left ventricular (LV) dimensions and function. The goal of this analysis was to determine the extent of reverse remodeling at 12 months after successful percutaneous reduction of MR with the MitraClip device.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00209339, NCT00209274.CONCLUSIONS: Patients with pre-existing LV dysfunction demonstrate reverse remodeling and improved LV ejection fraction after percutaneous mitral valve repair.METHODS AND RESULTS: Of 64 patients with 3 and 4+ MR who achieved acute procedural success after treatment with the MitraClip device, 49 patients had moderate or less MR at 12-month follow-up. Their baseline and 12-month echocardiograms were compared between the group with and without LV dysfunction. In patients with persistent MR reduction and pre-existing LV dysfunction, there was a reduction in LV wall stress, reduced LV end-diastolic volume, LV end-systolic volume and increase in LV ejection fraction in contrast to those with normal baseline LV function, who showed reduction in LV end-diastolic volume, LV wall stress, no 131223 in LV end-systolic volume, and a fall in LV ejection fraction.All authors: EVEREST Investigators, Fail PS, Feldman T, Foster E, Glower DD, Grayburn PA, Hermiller J, Herrmann HC, Kar S, Kwan D, Lim DS, Rinaldi MJ, Rogers JH, Schwartz A, Weissman NJ, Whitlow PLFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2013-12-24
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Journal Article MedStar Authors Catalog Article 23633132 Available 23633132

BACKGROUND: Percutaneous repair of mitral regurgitation (MR) permits examination of the effect of MR reduction without surgery and cardiopulmonary bypass on left ventricular (LV) dimensions and function. The goal of this analysis was to determine the extent of reverse remodeling at 12 months after successful percutaneous reduction of MR with the MitraClip device.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00209339, NCT00209274.

CONCLUSIONS: Patients with pre-existing LV dysfunction demonstrate reverse remodeling and improved LV ejection fraction after percutaneous mitral valve repair.

METHODS AND RESULTS: Of 64 patients with 3 and 4+ MR who achieved acute procedural success after treatment with the MitraClip device, 49 patients had moderate or less MR at 12-month follow-up. Their baseline and 12-month echocardiograms were compared between the group with and without LV dysfunction. In patients with persistent MR reduction and pre-existing LV dysfunction, there was a reduction in LV wall stress, reduced LV end-diastolic volume, LV end-systolic volume and increase in LV ejection fraction in contrast to those with normal baseline LV function, who showed reduction in LV end-diastolic volume, LV wall stress, no 131223 in LV end-systolic volume, and a fall in LV ejection fraction.

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