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Ischemic mitral regurgitation

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https://www.readbyqxmd.com/read/29232301/robotic-mitral-valve-repair-the-learning-curve
#1
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)...
December 7, 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
#2
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
#3
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
#4
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
#5
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
#6
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)...
January 1, 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
#7
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
#8
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
#9
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
#10
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 8, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29126782/feasibility-and-limitations-of-mitral-valve-repair-with-or-without-left-ventricular-reconstruction-in-non-ischemic-dilated-cardiomyopathy
#11
Yasushige Shingu, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
BACKGROUND: Although non-transplant surgical interventions for non-ischemic dilated cardiomyopathy (NIDCM) are relatively effective, their feasibility and limitations have not been fully elucidated. The aim of this study was to define the feasibility and limitations of mitral valve repair, with or without surgical ventricular reconstruction for patients with NIDCM in terms of postoperative low cardiac output syndrome (LOS). METHODS: Twenty non-transplant candidates (aged 57±13 years) with NIDCM and significant mitral regurgitation had undergone mitral valve repair combined with submitral procedures...
November 7, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29118948/transcatheter-heart-valve-in-valve-implantation-with-edwards-sapien-bioprosthetic-valve-for-different-degenerated-bioprosthetic-valve-positions-first-iranian-viv-report-with-mid-term-follow-up
#12
Ali Mohammad Haji Zeinali, Kyomars Abbasi, Mohammad Saheb Jam, Shahrooz Yazdani, Seyedeh Hamideh Mortazavi
Introduction: After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients. Methods: We performed five ViV procedures in different valve positions. We included patients with failing bioprosthetic valves with high surgical risk due to concomitant comorbidities. We performed 2 transapical ViV procedures for failing mitral bioprosthetic valves, 1 transfemoral procedure for failing pulmonary valve and 2 transfemoral ViV implantation for failing tricuspid bioprosthetic valves...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29104738/clinical-outcomes-of-tricuspid-valve-repair-accompanying-left-sided-heart-disease
#13
Kasra Azarnoush, Ahmad S Nadeemy, Bruno Pereira, Massoud A Leesar, Céline Lambert, Alaa Azhari, Vedat Eljezi, Nicolas Dauphin, Etienne Geoffroy, Lionel Camilleri
AIM: To determine whether the need for additional tricuspid valve repair is an independent risk factor when surgery is required for a left-sided heart disease. METHODS: One hundred and eighty patients (68 ± 12 years, 79 males) underwent tricuspid annuoplasty. Cox proportional-hazards regression model for multivariate analysis was performed for variables found significant in univariate analyses. RESULTS: Tricuspid regurgitation etiology was functional in 154 cases (86%), organic in 16 cases (9%), and mixed in 10 cases (6%), respectively...
October 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29101180/reduced-longitudinal-contraction-is-associated-with-ischemic-mitral-regurgitation-after-posterior-mi
#14
Kiyotake Ishikawa, Shin Watanabe, Nadjib Hammoudi, Jaume Aguero, Olympia Bikou, Kenneth Fish, Roger J Hajjar
BACKGROUND: The role of left ventricular (LV) longitudinal contraction in ischemic mitral regurgitation (MR) remains unclear. We hypothesized that reduced longitudinal contraction disrupts normal mitral valve plane displacement during systole and leads to mitral valve tethering, thereby inducing ischemic MR. METHODS: Twenty-three Yorkshire pigs underwent induction of different-sized posterior myocardial infarction (MI) using a percutaneous approach. Incidence of MR and its association to LV longitudinal strain was examined using speckle-tracking echocardiography at one month post-MI to determine their relationship...
November 3, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29100253/impact-of-papillary-muscle-infarction-on-ischemic-mitral-regurgitation-assessed-by-magnetic-resonance-imaging
#15
Christiane Bretschneider, Hannah-Klara Heinrich, Achim Seeger, Christof Burgstahler, Stephan Miller, Ulrich Kramer, Meinrad Gawaz, Konstantin Nikolaou, Bernhard Klumpp
Objective Ischemic mitral regurgitation is a predictor of heart failure resulting in increased mortality in patients with chronic myocardial infarction. It is uncertain whether the presence of papillary muscle (PM) infarction contributes to the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function. Methods and Materials 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included...
November 3, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29067354/associations-of-increased-arterial-stiffness-with-left-ventricular-ejection-performance-and-right-ventricular-systolic-pressure-in-mitral-regurgitation-before-and-after-surgery-wave-intensity-analysis
#16
Kiyomi Niki, Motoaki Sugawara, Hiroshi Kayanuma, Itaru Takamisawa, Hiroyuki Watanabe, Keitaro Mahara, Tetsuya Sumiyoshi, Takao Ida, Shuichiro Takanashi, Hitonobu Tomoike
BACKGROUND: The effect of increased arterial stiffness on mitral regurgitation (MR) is not clear. Using wave intensity (WI) analysis, which is useful for analyzing ventriculo-arterial interaction, we aimed to elucidate associations of increased arterial stiffness with left ventricular (LV) ejection performance and right ventricular systolic pressure (RVSP) in MR. METHODS AND RESULTS: We noninvasively measured carotid arterial WI and stiffness parameter (β) in 98 patients with non-ischemic chronic MR before and after surgery, and 98 age-and-gender matched healthy subjects by ultrasonography...
September 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29042413/mitral-leaflet-changes-following-myocardial-infarction-clinical-evidence-for-maladaptive-valvular-remodeling
#17
Jonathan Beaudoin, Jacob P Dal-Bianco, Elena Aikawa, Joyce Bischoff, J Luis Guerrero, Suzanne Sullivan, Philipp Emanuel Bartko, Mark D Handschumacher, Dae-Hee Kim, Jill Wylie-Sears, Jacob Aaron, Robert A Levine
BACKGROUND: Ischemic mitral regurgitation (MR) is classically ascribed to functional restriction of normal leaflets, but recent studies have suggested post-myocardial infarction (MI) mitral valve (MV) leaflet fibrosis and thickening, challenging valve normality. Progression of leaflet thickness post-MI has not been studied. We hypothesized that excessive MV remodeling post-MI contributes to MR. Our objectives are to characterize MV changes after MI and relate them to MR. METHODS AND RESULTS: Three groups of 40 patients with serial echocardiograms over a mean of 23...
November 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28994679/ischemic-mitral-regurgitation
#18
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
#19
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
#20
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
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