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Ischemic mitral regurgitation

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https://www.readbyqxmd.com/read/28994679/ischemic-mitral-regurgitation
#1
REVIEW
Praveen Kerala Varma, Neethu Krishna, Reshmi Liza Jose, Ashish Narayan Madkaiker
Ischemic mitral regurgitation (IMR) is a frequent complication of left ventricular (LV) global or regional pathological remodeling due to chronic coronary artery disease. It is not a valve disease but represents the valvular consequences of increased tethering forces and reduced closing forces. IMR is defined as mitral regurgitation caused by chronic changes of LV structure and function due to ischemic heart disease and it worsens the prognosis. In this review, we discuss on etiology, pathophysiology, and mechanisms of IMR, its classification, evaluation, and therapeutic corrective methods of IMR...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28961271/multiplanar-strain-quantification-for-assessment-of-right-ventricular-dysfunction-and-non-ischemic-fibrosis-among-patients-with-ischemic-mitral-regurgitation
#2
Antonino Di Franco, Jiwon Kim, Sara Rodriguez-Diego, Omar Khalique, Jonathan Y Siden, Samantha R Goldburg, Neil K Mehta, Aparna Srinivasan, Mark B Ratcliffe, Robert A Levine, Filippo Crea, Richard B Devereux, Jonathan W Weinsaft
BACKGROUND: Ischemic mitral regurgitation (iMR) predisposes to right ventricular (RV) pressure and volume overload, providing a nidus for RV dysfunction (RVDYS) and non-ischemic fibrosis (NIF). Echocardiography (echo) is widely used to assess iMR, but performance of different indices as markers of RVDYS and NIF is unknown. METHODS: iMR patients prospectively underwent echo and cardiac magnetic resonance (CMR) within 72 hours. Echo quantified iMR, assessed conventional RV indices (TAPSE, RV-S', fractional area change [FAC]), and strain via speckle tracking in apical 4-chamber (global longitudinal strain [RV-GLS]) and parasternal long axis orientation (transverse strain)...
2017: PloS One
https://www.readbyqxmd.com/read/28958332/protein-phosphatase-inhibitor-1-gene%C3%A2-therapy-in-a-swine-model-of-nonischemic%C3%A2-heart-failure
#3
Shin Watanabe, Kiyotake Ishikawa, Kenneth Fish, Jae Gyun Oh, Lukas J Motloch, Erik Kohlbrenner, Philyoung Lee, Chaoqin Xie, Ahyoung Lee, Lifan Liang, Changwon Kho, Lauren Leonardson, Maritza McIntyre, Scott Wilson, R Jude Samulski, Evangelia G Kranias, Thomas Weber, Fadi G Akar, Roger J Hajjar
BACKGROUND: Increased protein phosphatase-1 in heart failure (HF) induces molecular changes deleterious to the cardiac cell. Inhibiting protein phosphatase-1 through the overexpression of a constitutively active inhibitor-1 (I-1c) has been shown to reverse cardiac dysfunction in a model of ischemic HF. OBJECTIVES: This study sought to determine the therapeutic efficacy of a re-engineered adenoassociated viral vector carrying I-1c (BNP116.I-1c) in a preclinical model of nonischemic HF, and to assess thoroughly the safety of BNP116...
October 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28895197/impact-of-cardiac-resynchronization-therapy-on-mitral-valve-apparatus-geometry-and-clinical-outcomes-in-patients-with-secondary-mitral-regurgitation
#4
Christos G Mihos, Evin Yucel, Romain Capoulade, Mary P Orencole, Gaurav A Upadhyay, Orlando Santana, Jagmeet P Singh, Michael H Picard
BACKGROUND: Cardiac resynchronization therapy (CRT) may improve secondary mitral regurgitation (MR) in patients with cardiomyopathy. The effects on mitral valve (MV) and left ventricular (LV) geometry, however, have not been clearly defined. METHODS: Between 2009 and 2012, 229 CRT implants were performed at a single academic center. Seventy-one had ≥mild MR at baseline and serial echocardiography, without subsequent MV intervention. The pre-CRT and follow-up echocardiograms were retrospectively reviewed for (1) MV and LV geometry measurements; (2) MR grade; and (3) LV remodeling indices...
September 12, 2017: Echocardiography
https://www.readbyqxmd.com/read/28895061/valvular-heart-disease-in-women-differential-remodeling-and-response-to-new-therapies
#5
REVIEW
Jaya Chandrasekhar, George Dangas, Roxana Mehran
In the United States, valvular heart disease (VHD) has a prevalence of 2.5%, most commonly presenting as aortic stenosis (AS) or mitral valve regurgitation (MR) and increasingly observed to be of a degenerative etiology. Women frequently have latent symptoms despite significant disease, and it is therefore pertinent to consider both clinical symptoms and imaging findings for decision-making on treatment. Indeed, significant advances have been made in noninvasive imaging allowing for more accurate diagnosis and disease prognostication...
September 11, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28893396/early-results-of-robotically-assisted-mitral-valve-surgery-analysis-of-the-first-1000-cases
#6
A Marc Gillinov, Tomislav Mihaljevic, Hoda Javadikasgari, Rakesh M Suri, Stephanie L Mick, José L Navia, Milind Y Desai, Johannes Bonatti, Mitra Khosravi, Jay J Idrees, Ashley M Lowry, Eugene H Blackstone, Lars G Svensson
OBJECTIVE: The study objective was to assess the technical and process improvement and clinical outcomes of robotic mitral valve surgery by examining the first 1000 cases performed in a tertiary care center. METHODS: We reviewed the first 1000 patients (mean age, 56 ± 10 years) undergoing robotic primary mitral valve surgery, including concomitant procedures (n = 185), from January 2006 to November 2013. Mitral valve disease cause was degenerative (n = 960, 96%), endocarditis (n = 26, 2...
August 1, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28877291/survival-and-cardiovascular-outcomes-of-patients-with-secondary-mitral-regurgitation-a-systematic-review-and-meta-analysis
#7
Anna Sannino, Robert L Smith, Gabriele G Schiattarella, Bruno Trimarco, Giovanni Esposito, Paul A Grayburn
Importance: The outcomes of patients with left ventricular (LV) dysfunction and secondary mitral regurgitation (SMR) are still controversial. Objective: To clarify the role of SMR in the outcomes of patients with ischemic or idiopathic cardiomyopathies. Data Sources: MEDLINE, ISI Web of Science, and Scopus databases were searched for studies published up to March 2017. Study Selection: Studies reporting data on outcomes in patients with SMR were included...
September 6, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28859787/new-pharmacological-target-to-treat-ischemic-mitral-regurgitation-thinking-outside-the-box
#8
EDITORIAL
Luc A Pierard, Julien Magne
No abstract text is available yet for this article.
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28859786/effect-of-losartan-on-mitral-valve-changes-after-myocardial-infarction
#9
Philipp E Bartko, Jacob P Dal-Bianco, J Luis Guerrero, Jonathan Beaudoin, Catherine Szymanski, Dae-Hee Kim, Margo M Seybolt, Mark D Handschumacher, Suzanne Sullivan, Michael L Garcia, James S Titus, Jill Wylie-Sears, Whitney S Irvin, Emmanuel Messas, Albert A Hagège, Alain Carpentier, Elena Aikawa, Joyce Bischoff, Robert A Levine
BACKGROUND: After myocardial infarction (MI), mitral valve (MV) tethering stimulates adaptive leaflet growth, but counterproductive leaflet thickening and fibrosis augment mitral regurgitation (MR), doubling heart failure and mortality. MV fibrosis post-MI is associated with excessive endothelial-to-mesenchymal transition (EMT), driven by transforming growth factor (TGF)-β overexpression. In vitro, losartan-mediated TGF-β inhibition reduces EMT of MV endothelial cells. OBJECTIVES: This study tested the hypothesis that profibrotic MV changes post-MI are therapeutically accessible, specifically by losartan-mediated TGF-β inhibition...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28838478/2-year-outcomes-after-transcatheter%C3%A2-mitral-valve-replacement
#10
Ander Regueiro, Jian Ye, Neil Fam, Vinayak N Bapat, François Dagenais, Mark D Peterson, Stephan Windecker, John G Webb, Josep Rodés-Cabau
OBJECTIVES: This study sought to determine late (2-year) outcomes following transcatheter mitral valve replacement (TMVR) with the FORTIS valve (Edwards Lifesciences, Irvine, California). BACKGROUND: No data exist on long-term clinical outcomes following TMVR in patients with severe native mitral regurgitation (MR). METHODS: This multicenter registry included consecutive patients with severe MR who underwent TMVR with the FORTIS valve under a compassionate clinical use program...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28820540/endoscopic-port-access-surgery-for-late-orthotopic-cardiac-transplantation-atrioventricular-valve-disease
#11
Johan van der Merwe, Filip Casselman, Bernard Stockman, Yvette Vermeulen, Ivan Degrieck, Frank Van Praet
BACKGROUND: The study aim was to present details of the perioperative and long-term outcomes of redo-endoscopic port access surgery (REPAS) for late atrioventricular valve disease (AVVD) in orthotopic cardiac transplant (OCT) patients. METHODS: Between February 2004 and October 2015, REPAS was performed for late AVVD in seven consecutive OCT patients (mean age 57.9 ± 17.2 years; EuroSCORE II 21.2 ± 14.7%) at the authors' institution. The mean OCT-REPAS time interval was 7...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820034/the-value-of-adding-sub-valvular-procedures-for-chronic-ischemic-mitral-regurgitation-surgery-a-meta-analysis
#12
Marco Moscarelli, Thanos Athanasiou, Giuseppe Speziale, Prakash P Punjabi, George Malietzis, Patrizio Lancellotti, Khalil Fattouch
BACKGROUND: The most performed repair technique for the treatment of chronic ischemic mitral regurgitation in patients referred for bypass grafting remains restricted annuloplasty. However, it is associated with a high rate of failure, especially if severe tenting exists. OBJECTIVES: To understand if adjunctive sub-valvular mitral procedures may provide better repair performance. METHODS: A systematic literature review identified six studies of which five fulfilled the criteria for meta-analysis...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28803350/comparison-of-mitral-competence-after-mitral-repair-with-papillary-muscle-approximation-versus-papillary-muscle-relocation-for-functional-mitral-regurgitation
#13
Koji Furukawa, Mitsuhiro Yano, Eisaku Nakamura, Masakazu Matsuyama, Masanori Nishimura, Katsuya Kawagoe, Kunihide Nakamura
The purpose of this study was to evaluate the surgical results of papillary muscle approximation (PMA) and papillary muscle relocation (PMR) for functional mitral regurgitation (FMR) and to compare the effects of both procedures on the change in mitral regurgitation (MR) and echocardiogram parameters associated with tethering. Eighteen patients with moderate-to-severe FMR (MR grade ≥2) who underwent PMA or PMR were retrospectively analyzed. Underlying diseases were ischemic cardiomyopathy, idiopathic dilated cardiomyopathy, and aortic valve disease for seven, six, and five patients, respectively...
August 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28800856/-impact-of-mitral-annuloplasty-combined-with-surgical-revascularization-in-ischemic-mitral-regurgitation
#14
M Tribak, M Konaté, B Ould Hbib, P Konan, L Mahfoudi, A El Hassani, A Daouda, F Lachhab, N Bendagha, A Soufiani, J Fila, S Maghraoui, A Bensouda, L Marmade, S Moughil
INTRODUCTION: Ischemic Mitral Regurgitation (IMR) is a serious complication of coronary artery disease and is associated with a poor prognosis. The optimal surgical treatment of IMR involves controversies in its indications and modalities. OBJECTIVES: To determine whether mitral annuloplasty associated with surgical revascularization improved short and mid terms outcomes compared with revascularization alone in patients with IMR. METHODS: Between January 2007 and January 2011, 81 patients operated on Department of Cardiovascular Surgery "B" were included in this study divided into 3 groups...
August 8, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28740718/papillary-muscle-approximation-in-mitral-valve-repair-for-secondary-mr
#15
REVIEW
Francesco Nappi, Cristiano Spadaccio, Massimo Chello, Christos G Mihos
Ischemic mitral regurgitation (IMR) is a complex disorder occurring after a myocardial infarction and affecting both the mitral valvular and subvalvular apparati. Several abnormalities can be detected in IMR as annular dilatation, leaflet tethering with impaired coaptation and papillary muscle (PM) displacement along a posterior, apical or lateral vectors. Treatments available include, beside myocardial revascularization, mitral-valve repair or chordal-sparing replacement. Repair is normally achieved downsizing the mitral valve annulus with a rigid or semirigid ring...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740716/biomechanics-raises-solution-to-avoid-geometric-mitral-valve-configuration-abnormalities-in-ischemic-mitral-regurgitation
#16
REVIEW
Francesco Nappi, Cristiano Spadaccio, Christos G Mihos, Massimiliano Fraldi
Ischemic mitral regurgitation (IMR) is a form of mitral insufficiency that is characterized by papillary muscle (PM) displacement, leaflet tethering, reduced closing forces, and different degree of annular dilatation. Treatment of this condition includes mitral valve replacement or mitral valve repair with restrictive annuloplasty. Recent evidences in mitral valve repair showed that addressing only the annulus and neglecting the subvalvular apparatus provides a suboptimal operation with poor long-term results...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740711/mitral-valve-repair-and-subvalvular-intervention-for-secondary-mitral-regurgitation-a-systematic-review-and-meta-analysis-of-randomized-controlled-and-propensity-matched-studies
#17
Christos G Mihos, Steve Xydas, Evin Yucel, Romain Capoulade, Roy F Williams, Maurice Mawad, Guillermo Garcia, Orlando Santana
BACKGROUND: Combining a ring annuloplasty (Ring) with a mitral subvalvular intervention (Ring + subvalvular) in patients with secondary mitral regurgitation (MR) may improve mitral valve (MV) repair durability. However, the outcomes of this strategy compared with a Ring only, have not been clearly defined. METHODS: A systematic review and meta-analysis was performed utilizing randomized controlled and propensity matched studies which compared a Ring + subvalvular versus Ring MV repair for the treatment of secondary MR...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740708/staged-percutaneous-coronary-intervention-followed-by-minimally-invasive-mitral-valve-surgery-versus-combined-coronary-artery-bypass-graft-and-mitral-valve-surgery-for-two-vessel-coronary-artery-disease-and-moderate-to-severe-ischemic-mitral-regurgitation
#18
Christos G Mihos, Steve Xydas, Roy F Williams, Andrés M Pineda, Evin Yucel, Hector Davila, Nirat Beohar, Orlando Santana
BACKGROUND: The optimal treatment for concomitant two-vessel coronary artery disease (CAD) and moderate to severe ischemic mitral regurgitation (IMR) remains unclear. We compared the results of a staged percutaneous coronary intervention followed by minimally invasive mitral valve surgery (PCI+MIVS) versus combined coronary artery bypass graft and mitral valve surgery (CABG+MVS) in this population. METHODS: All consecutive patients with two-vessel CAD and moderate to severe IMR, who underwent PCI+MIVS or CABG+MVS at our institution between February 2009 and April 2014, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28711330/toward-a-better-repair-for-ischemic-mitral-regurgitation-thinking-outside-the-ring
#19
EDITORIAL
Judy Hung, Christos Mihos
No abstract text is available yet for this article.
June 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28705383/ischemic-or-nonischemic-functional-mitral-regurgitation-and-outcomes-in-patients-with-acute-decompensated-heart-failure-with-preserved-or-reduced-ejection-fraction
#20
MULTICENTER STUDY
Katsuya Kajimoto, Yuichiro Minami, Shigeru Otsubo, Naoki Sato
The aim of this study was to evaluate the association of functional mitral regurgitation (FMR), preserved or reduced ejection fraction (EF), and ischemic or nonischemic origin with outcomes in patients discharged alive after hospitalization for acute decompensated heart failure (HF). Of the 4,842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 3,357 patients were evaluated to assess the association of FMR, preserved or reduced EF, and ischemic or nonischemic origin with the primary end point (all-cause death and readmission for HF after discharge)...
September 1, 2017: American Journal of Cardiology
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