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Ischemic mitral regurgitation

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https://www.readbyqxmd.com/read/29399763/significant-mitral-regurgitation-predicts-the-long-term-prognosis-in-patients-receiving-cardiac-resynchronization-therapy
#1
Han Jin, Shengwen Yang, Wei Hua, Min Gu, Hongxia Niu, Ligang Ding, Jing Wang, Cong Xue, Shu Zhang
BACKGROUND: Cardiac resynchronization therapy (CRT) has been shown to reduce Functional mitral regurgitation (FMR), although the relationship between significant mitral regurgitation (SMR) and the clinical prognosis of CRT remains uncertain. AIM: To investigate the association of baseline of SMR with long-term outcomes in patients undergoing CRT. METHODS: A total of 296 consecutive patients undergoing CRT were enrolled. SMR was quantified by color Doppler in all the patients at baseline and defined as grading scale ≥ 3...
February 5, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29391146/ischemic-mitral-regurgitation-abnormal-strain-overestimates-non-viable-myocardium
#2
Ashley E Morgan, Yue Zhang, Mehrzad Tartibi, Samantha Goldburg, Jiwon J Kim, Thanh D Nguyen, Julius Guccione, Liang Ge, Jonathan W Weinsaft, Mark B Ratcliffe
BACKGROUND: Therapy for moderate ischemic mitral regurgitation (IMR) remains unclear. Determination of myocardial viability, a necessary pre-requisite for an improvement in regional contractility, is a likely key factor in determining response to revascularization alone. Myocardial strain has been proposed as a viability measure but has not been compared to late gadolinium enhancement (LGE) cardiac (c)MRI. We hypothesized that abnormal strain overestimates non-viable LV segments measured using LGE and that ischemia and mechanical tethering by adjacent transmural myocardial infarction (TMI) also decreases strain in viable segments...
January 29, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29387972/effect-of-cardiac-resynchronization-therapy-on-mitral-valve-geometry-a-novel-aspect-as-reversed-mitral-remodeling
#3
Oguz Karaca, Beytullah Cakal, Mehmet Onur Omaygenc, Haci Murat Gunes, Filiz Kizilirmak, Sinem Deniz Cakal, Deniz Dilan Naki, Irfan Barutcu, Bilal Boztosun, Fethi Kilicaslan
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...
January 31, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29367688/mitral-valve-annuloplasty-versus-replacement-for-severe-ischemic-mitral-regurgitation
#4
Baotong Li, Shanglin Chen, Hansong Sun, Jianping Xu, Yunhu Song, Wei Wang, Shuiyun Wang
Although practice guidelines recommend surgery for patients with severe chronic ischemic mitral regurgitation (CIMR), they do not specify whether to repair or replace the mitral valve. 436 consecutive patients with severe CIMR were eligible for inclusion in the study, of which 316 (72.5%) underwent mitral valve annuloplasty (MVA) whereas 120 (27.5%) received mitral valve replacement (MVR). At 59 months (interquartile range, 37-85 months) follow-up, though the left ventricle end-diastolic diameter was markedly larger (P = 0...
January 24, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29342024/clinical-profile-of-patients-with-heart-failure-can-predict-rehospitalization-and-quality-of-life
#5
Michele Di Mauro, Renata Petroni, Daniela Clemente, Massimiliano Foschi, Fabrizio Tancredi, Virginia Camponetti, Sabina Gallina, Antonio M Calafiore, Maria Penco, Silvio Romano
BACKGROUND: The aim of this retrospective study was to identify clinical, humoral and echocardiographic variables predicting rehospitalization and poor quality of life (QOL) in patients with reduced or mid-range ejection fraction heart failure. METHODS: From 2009 to 2012, 310 patients were admitted having signs and symptoms of heart failure with reduced ejection fraction. All the patients were followed by phone, calling the patients or the referring general practitioner...
March 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29321130/exercise-hemodynamic-and-functional-capacity-after-mitral-valve-replacement-in-patients-with-ischemic-mitral-regurgitation-a-comparison-of-mechanical-versus-biological-prostheses
#6
Carlo Fino, Attilio Iacovoni, Philippe Pibarot, John R Pepper, Paolo Ferrero, Maurizio Merlo, Lorenzo Galletti, Massimo Caputo, Paolo Ferrazzi, Constantinos Anagnostopoulos, Diego Cugola, Michele Senni, Diego Bellavia, Julien Magne
BACKGROUND: In patients with ischemic mitral regurgitation requiring mitral valve replacement (MVR), the choice of the prosthesis type is crucial. The exercise hemodynamic and functional capacity performance in patients with contemporary prostheses have never been investigated. To compare exercise hemodynamic and functional capacity between biological (MVRb) and mechanical (MVRm) prostheses. METHODS AND RESULTS: We analyzed 86 consecutive patients with ischemic mitral regurgitation who underwent MVRb (n=41) or MVRm (n=45) and coronary artery bypass grafting...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29291344/diagnosis-and-management-of-ischemic-mitral-regurgitation-evidence-based-clinical-decision-making-at-the-point-of-care
#7
Ajay Kumar Jha, Vishwas Malik
Anatomical, functional, and pathophysiologic mechanisms of ischemic mitral regurgitation (IMR) are markedly different from the primary mitral regurgitation. The older and ubiquitous cutoff of EROA (effective regurgitant orifice area) and Rvol (regurgitant volume) for IMR has been reinstated in the new guideline after a brief hiatus. There had always been a lack of good-quality evidence for its introduction for guiding IMR severity in the previous guideline, and we still do not have quality evidences that could justify its reintroduction...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29285527/spatiotemporal-segmentation-and-modeling-of-the-mitral-valve-in-real-time-3d-echocardiographic-images
#8
Alison M Pouch, Ahmed H Aly, Eric K Lai, Natalie Yushkevich, Rutger H Stoffers, Joseph H Gorman, Albert T Cheung, Joseph H Gorman, Robert C Gorman, Paul A Yushkevich
Transesophageal echocardiography is the primary imaging modality for preoperative assessment of mitral valves with ischemic mitral regurgitation (IMR). While there are well known echocardiographic insights into the 3D morphology of mitral valves with IMR, such as annular dilation and leaflet tethering, less is understood about how quantification of valve dynamics can inform surgical treatment of IMR or predict short-term recurrence of the disease. As a step towards filling this knowledge gap, we present a novel framework for 4D segmentation and geometric modeling of the mitral valve in real-time 3D echocardiography (rt-3DE)...
September 2017: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
https://www.readbyqxmd.com/read/29273635/prevalence-characteristics-and-outcomes-of-valvular-heart-disease-in-patients-with-atrial-fibrillation-insights-from-the-orbit-af-outcomes-registry-for-better-informed-treatment-for-atrial-fibrillation
#9
Kevin L Thomas, Larry R Jackson, Peter Shrader, Jack Ansell, Gregg C Fonarow, Bernard Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Laine Thomas, Jonathan P Piccini, Eric D Peterson
BACKGROUND: The presence of valvular heart disease (VHD) may affect the risk of stroke and mortality in patients with atrial fibrillation (AF). Community-based estimates of prevalence and outcomes of specific forms of VHD in patients with AF are lacking. METHODS AND RESULTS: We examined the prevalence of VHD, anticoagulation use, mortality, stroke/transient ischemic attack, and bleeding among a community cohort of patients with AF. Significant VHD was defined as follows: (1) moderate/severe mitral stenosis or mechanical valve; (2) bioprosthetic valve, surgical repair, or balloon valvuloplasty; and (3) moderate/severe aortic regurgitation or stenosis, mitral regurgitation, or tricuspid regurgitation...
December 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29249485/application-of-polymer-mesh-device-to-remodel-left-ventricular-mitral-valve-apparatus-in-ischemic-mitral-regurgitation
#10
Akihisa Kataoka, Xin Zeng, J Luis Guerrero, Adam Kozak, Gavin Braithwaite, Robert A Levine, Gus J Vlahakes, Judy Hung
OBJECTIVES: Ischemic mitral regurgitation (IMR) results from ischemic left ventricular (LV) distortion and remodeling, which displaces the papillary muscles and tethers the mitral valve leaflets apically. The aim of this experimental study was to examine efficacy of an adjustable novel polymer filled mesh (poly-mesh) device to reverse LV remodeling and reduce IMR. METHODS: Acute (N = 8) and chronic (8 weeks; N = 5) sheep models of IMR were studied. IMR was produced by ligation of circumflex branches to create myocardial infarction...
November 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29232301/robotic-mitral-valve-repair-the-learning-curve
#11
Avi Goodman, Marijan Koprivanac, Marta Kelava, Stephanie L Mick, A Marc Gillinov, Jeevanantham Rajeswaran, Anna Brzezinski, Eugene H Blackstone, Tomislav Mihaljevic
OBJECTIVE: Adoption of robotic mitral valve surgery has been slow, likely in part because of its perceived technical complexity and a poorly understood learning curve. We sought to correlate changes in technical performance and outcome with surgeon experience in the "learning curve" part of our series. METHODS: From 2006 to 2011, two surgeons undertook robotically assisted mitral valve repair in 458 patients (intent-to-treat); 404 procedures were completed entirely robotically (as-treated)...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29216983/atrial-infarction-and-ischemic-mitral-regurgitation-contribute-to-post-mi-remodeling-of-the-left-atrium
#12
Jaume Aguero, Carlos Galan-Arriola, Rodrigo Fernandez-Jimenez, Javier Sanchez-Gonzalez, Nina Ajmone, Victoria Delgado, Jorge Solis, Gonzalo J Lopez, Antonio de Molina-Iracheta, Roger J Hajjar, Jeroen J Bax, Valentin Fuster, Borja Ibáñez
BACKGROUND: Left atrial (LA) remodeling after an acute myocardial infarction (MI) is poorly characterized regarding its determinants or its effect on ischemic mitral regurgitation (MR) development. OBJECTIVES: The purpose of this study was: 1) to compare LA structural remodeling in experimental MI swine models recapitulating the effects of left ventricular (LV) dysfunction, ischemic MR, and left atrial infarction (LAI); and 2) to analyze how LA remodeling influences ischemic MR development...
December 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29204737/initial-slovenian-experience-with-mitraclip-therapy-careful-selection-of-patients-is-crucial-for-optimal-outcome
#13
Jana Ambrožič, Marta Cvijič, Mojca Bervar, Špela Mušič, Matjaž Bunc
BACKGROUND: MitraClip is a percutaneous mitral repair technology increasingly used for high surgical risk patients with primary or secondary mitral regurgitation. We describe initial Slovenian experience with MitraClip and discuss the importance of identifying the suitable candidates for this procedure. METHODS: We retrospectively analyzed the first 10 patients (mean age 75.6 ± 6.9 years, logistic Euroscore 28.4 ± 10.9%) with severe and moderate to severe mitral regurgitation (8 secondary, 1 primary and 1 mixed etiology) who underwent a MitraClip procedure between January 2015 and February 2017...
December 4, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29203301/ischemic-mitral-regurgitation-a-paradigm-shift-in-surgical-management
#14
REVIEW
Anita K Malhotra, Adam S Evans, Menachem M Weiner, Harish Ramakrishna
No abstract text is available yet for this article.
June 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29202813/a-predominance-of-hypertensive-heart-disease-among-patients-with-cardiac-disease-in-buea-a-semi-urban-setting-south-west-region-of-cameroon
#15
Clovis Nkoke, Christelle Makoge, Anastase Dzudie, Liliane Kuate Mfeukeu, Engelbert Bain Luchuo, Alain Menanga, Samuel Kingue
OBJECTIVE: The pattern of heart disease is diverse within and among world regions. The little data on the spectrum of heart disease in Cameroon has been so far limited to major cities. We sought to describe the pattern of heart disease in Buea, the South West Region of Cameroon, a semi-urban setting. This was a descriptive cross-sectional study. Between June 2016 and April 2017 the echocardiography register of the Buea Regional Hospital was surveyed. We extracted data on the age, sex and echocardiographic diagnosis...
December 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29153000/coronary-bypass-in-left-ventricular-dysfunction-and-differential-cardiac-recovery
#16
Lucian Lozonschi, Takushi Kohmoto, Satoru Osaki, Nilto C De Oliveira, Ravi Dhingra, Shahab A Akhter, Paul C Tang
Background We aimed to examine the efficacy of surgical revascularization with respect to improvement in ventricular function and survival in patients with ischemic cardiomyopathy and poor left ventricular function. Methods We retrospectively analyzed the data of 429 patients (median age 64.6 years, 81.1% male) with ejection fractions <40% undergoing isolated primary coronary artery bypass grafting from 2000 to 2016. Techniques included on-pump cardioplegic arrest ( n = 312), off-pump ( n = 75), and on-pump beating heart ( n = 42)...
November 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29150492/predictors-of-mortality-in-patients-with-severe-ischemic-cardiomyopathy-undergoing-surgical-mitral-valve-intervention
#17
Kenya Kusunose, Nancy A Obuchowski, Marc Gillinov, Zoran B Popovic, Scott D Flamm, Brian P Griffin, Deborah H Kwon
BACKGROUND: Ischemic mitral regurgitation is associated with substantial risk of death. Although surgical mitral valve intervention (MVi) may improve symptoms, it has not been shown to improve survival. The aim of this study was to identify predictors of mortality in patients with ischemic mitral regurgitation and MVi. METHODS AND RESULTS: We evaluated 117 consecutive patients (age, 65±10 years) with advanced ischemic cardiomyopathy who underwent cardiac magnetic resonance and subsequent MVi between January 1, 2002 and January 1, 2012...
November 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29132918/the-first-in-human-experience-with-a-minimally-invasive-ambulatory-counterpulsation-heart-assist-system-for-advanced-congestive-heart-failure
#18
Valluvan Jeevanandam, Tae Song, David Onsager, Takeyoshi Ota, Colleen Juricek LaBuhn, Thomas Lammy, Gabriel Sayer, Gene Kim, Sonna Patel-Raman, Nir Uriel
BACKGROUND: The intravascular ventricular assist system (iVAS) is a new, minimally invasive, ambulatory counterpulsation heart assist system delivered via the subclavian artery and powered by a portable driver. It is designed for recovery, bridge to transplantation (BTT) or for prolonging medical therapy. We report the first-in-human (FIH) experience with iVAS. METHODS: This is a prospective, non-randomized single arm, U.S. Food and Drug Administration (FDA)-approved early feasibility trial in patients listed for cardiac transplantation...
November 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29128571/exercise-testing-in-mitral-regurgitation
#19
REVIEW
Raluca Dulgheru, Stella Marchetta, Tadafumi Sugimoto, Yun Yun Go, Alexandra Girbea, Oury Cécile, Patrizio Lancellotti
Mitral regurgitation (MR) is the second most common valvular heart disease referred for corrective surgery. Diagnostic and management dilemmas are not uncommon when dealing with MR patients. Exercise testing plays an important role in sorting out some of these clinical challenges. In primary asymptomatic MR, exercise testing allows symptom assessment, confident link of symptoms to valve disease severity, safe deferral of surgery for the next 1-year in patients with preserved exercise capacity, insights into the mechanism of exercise-induced dyspnea and helps in individual risk stratification...
November 8, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29128570/outcomes-in-degenerative-mitral-regurgitation-current-state-of-the-art-and-future-directions
#20
REVIEW
Milind Y Desai, Francesco Grigioni, Marco Di Eusanio, Matteo Saccocci, Maurizio Taramasso, Francesco Maisano, Rakesh M Suri, A Marc Gillinov
Mitral regurgitation (MR) is the one of the most frequent valvular heart diseases in the developed world, often requiring surgical correction. Degenerative MR is the most common type of non-ischemic, organic MR in the western world. Since no medical treatment has been shown to be effective in preventing the consequences of volume overload in asymptomatic degenerative MR, risk stratification is essential. Currently, this is achieved using clinical and precisely quantified echocardiographic parameters, with newer technologies like cardiac magnetic resonance gaining increasing prominence...
November 9, 2017: Progress in Cardiovascular Diseases
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