ECR 2013 Book of Abstracts - B - Scientific Sessions

Abstract

Purpose: Consecutive mitral regurgitation after myocardial infarction and secondary ventricular dilatation results in a bad prognosis and high surgical risk due to cardiac comorbidity. Mitral clipping (MitraClip, Abbott Vascular) is a minimal-invasive percutaneous interventional palliative method to reduce mitral regurgitation. The purpose of this study was to evaluate pre-and postinterventional cardiac function and to quantify the degree of left atrial dilatation. Methods and Materials: 21 patients were prospectively included in this study. Magnetic resonance imaging (MRI) was performed before and 6 weeks after intervention. Cardiac function was evaluated using steady-state free precession (SSFP) cine sequences by assessment of enddiastolic volume (EDV), ejection fraction (EF). Planimetry of the left atrium (LA) was performed in identical slices in four-chamber view. Paired statistical analysis was applied. Results: 16 patients underwent postinterventional MRI. In paired analysis, mean difference in pre-and postinterventional MRI was for EDV -7.5 ml (95% upper confidence interval [UCI] -1.0 ml, 95% lower CI (LCI) -14.1 ml); for EF +3.9% (UCI 6.8%, LCI 1.0%); for LA -2.6 cm² (UCI -1.5 cm², LCI -3.8 ml) (p < 0.05). Conclusion:The quantifiable left atrial dilatation decreased significantly as an indirect sign of reduced mitral regurgitation. EDV decreased in 81% of the patients. Postinterventional ejection fraction improved particularly in patients with initially low EF, in two patients EF did not improve. This can be considered as success of the palliative intervention in seriously ill patients. The clinical benefit of a successful MitraClip intervention can be monitored and validated using MRI in clinical follow-up examinations. B-0004 10:57Pre-and post-interventional analysis of myocardial strain in patients undergoing mitral valve clipping using cardiac MRI P. Krumm, C.S. Zuern, T.H. Wurster, A. Seeger, S. Mangold, B. Klumpp, C.D. Claussen, A. May, U. Kramer; Tübingen/ DE (patrickkrumm@gmail.com) Purpose: Percutaneous interventional mitral clipping (MitraClip, Abbott Vascular) is performed to reduce mitral regurgitation. Effects of the intervention on myocardial strain were examined with a new feature tracking software. Methods and Materials: 20 patients were prospectively included in this study. Magnetic resonance imaging (MRI) was performed before and 6 weeks after successful intervention. Myocardial strain analysis was performed using a dedicated feature tracking software (2D CPA MR, TomTec) based on steady-state free precession (SSFP) cine sequences in four-chamber view (4CV) and short axis (SA). Longitudinal myocardial strain was evaluated quantitatively using the timeto-peak (T2P) and peak value analysis. Paired statistical analysis was applied for pre-and post-interventional peak and T2P values for each myocardial segment and average values. Results: 15 patients underwent post-interventional follow-up MRI. In paired strain analysis, arithmetic mean of differences for T2P was 63.3 ms (± 100, 7 ms), fo...