| Impact of Mitral Regurgitation on Reverse Remodeling and Outcome in Patients Undergoing Cardiac Resynchronization Therapy. | |
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MedLine Citation:
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PMID: 22047983 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: -MR is associated with reduced survival in patients with chronic heart failure, but may be improved with CRT. We sought to evaluate the relationship between serial measurements of functional mitral regurgitation (MR) and reverse remodeling and outcomes in patients undergoing cardiac resynchronization therapy (CRT). METHODS AND RESULTS: -266 consecutive patients undergoing CRT with available baseline echocardiograms and subsequent clinical and echocardiographic follow-up were included in the analysis. Long-term follow-up included all-cause mortality, heart transplantation, and implantation of a left ventricular assist device. Temporal changes in MR severity and left ventricular end systolic volume index (LVESVi) were evaluated by linear mixed model analysis. CRT led to immediate sustained decrease in MR (p <0.0001) with no significant subsequent change. The amount of MR decrease correlated with a greater decrease in LVESVi late (p = <0.0001), but not early (p = 0.14) after CRT start. Patients with severe MR pre CRT experienced larger LVESVi decrease (p=0.005). Whereas baseline MR severity was not associated with adverse events (p=0.13), larger MR decrease (p = 0.001) and smaller residual MR after the initial 6 months of CRT (p = 0.03) were predictive of better outcome in a multivariable model. CONCLUSIONS: -Early reversal of functional MR was associated with reverse cardiac remodeling and improved outcomes. Patients with moderately severe to severe MR prior to CRT experienced relatively more reverse remodeling than patients with lesser degrees of MR. |
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Authors:
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David Verhaert; Zoran B Popovic; Sabe De; Chirapa Puntawangkoon; Kathy Wolski; Bruce L Wilkoff; Randall C Starling; W H Wilson Tang; James D Thomas; Brian P Griffin; Richard A Grimm |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-2 |
Journal Detail:
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Title: Circulation. Cardiovascular imaging Volume: - ISSN: 1942-0080 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101479935 Medline TA: Circ Cardiovasc Imaging Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Cleveland Clinic, Cleveland, OH. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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