Effect of Functional Mitral Regurgitation on Outcome in Patients Receiving Cardiac Resynchronization Therapy for Heart Failure

Bijl, Pieter van der; Khidir, Mand J.H.; Marsan, Nina Ajmone; Delgado, Victoria; Leon, Martin B.; Stone, Gregg W.; Bax, Jeroen J.

doi:10.1016/j.amjcard.2018.09.020

Cited by 31 publications

(11 citation statements)

References 29 publications

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“…LV diastolic dysfunction is a common finding in HF with reduced LVEF and may lead to elevated LV filling pressures, which increase LA afterload. In addition, functional mitral regurgitation is frequently found in HF patients, 4 and may impose an additional volume overload on the thin-walled LA, leading to LA structural remodelling. 21 LA remodelling is accompanied by an increase in interstitial fibrosis of the atrial wall, leading to a progressive reduction in LA compliance.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Previous studies have demonstrated that improvement in LV global longitudinal strain (GLS), which quantifies active myocardial deformation and is a more robust marker of LV performance than LVEF, 2 is independently associated with improved outcomes in CRT recipients. 3 In addition, CRT has the potential to reduce functional mitral regurgitation severity 4 and to improve LV diastolic function, 5 , 6 which may lead to left atrial (LA) reverse remodelling. 7 , 8 LA reverse remodelling has been linked to better cardiovascular outcomes in patients with HF receiving CRT.…”

Section: Introductionmentioning

confidence: 99%

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Clinical implications of left atrial reverse remodelling after cardiac resynchronization therapy

Stassen

Galloo

Chimed

et al. 2022

European Heart Journal - Cardiovascular Imaging

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Aims Left atrial (LA) function is a marker of prognosis in patients with heart failure. The prognostic implications of an improvement in LA function in addition to an improvement in left ventricular (LV) function after cardiac resynchronization therapy (CRT) implantation are unknown. This study aimed to evaluate the prognostic value of a significant change in LA reservoir strain (RS) and/or LV global longitudinal strain (GLS) after initiation of CRT. Methods and results LARS and LVGLS were measured with speckle-tracking echocardiography. Significant improvement in LARS and LVGLS was defined as a percentage change of +5% and +20% at 6 months after CRT implantation, respectively. Patients were divided into three groups: no significant reverse remodelling (no improvement in LARS and LVGLS), incomplete reverse remodelling (improvement in LARS or LVGLS), and complete reverse remodelling (improvement in LARS and LVGLS). The primary endpoint was all-cause mortality. A total of 923 patients (mean age 65 ± 10 years, 77% male) were included, of which 221 (24%) had complete reverse remodelling, 414 (45%) incomplete reverse remodelling, and 288 (31%) no significant reverse remodelling. Five-years’ mortality was 24%, 29%, and 36% for patients with complete, incomplete, and no significant reverse remodelling, respectively (P < 0.001). On multivariable analysis, complete reverse remodelling (hazard ratio 0.477; 95% confidence interval: 0.362–0.628; P < 0.001) was associated with the lowest risk of mortality. Conclusions Patients with complete reverse remodelling have a lower mortality risk than those showing incomplete or no significant reverse remodelling. The use of integrated LA and LV deformation imaging may improve risk-stratification of CRT recipients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical implications of left atrial reverse remodelling after cardiac resynchronization therapy

Stassen

Galloo

Chimed

et al. 2022

European Heart Journal - Cardiovascular Imaging

Self Cite

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“…The FMR changes were related to 6 months response to CRT. 26 Solis et al evaluated FMR before and 6 months after CRT using 3D echocardiography parameters. The principal objective of this study was to examine the effects of CRT on the mitral valve.…”

Section: Methods Used For Fmr Evaluation Short-term After Crtmentioning

confidence: 99%

"Surgical approach in a patient with intestinal malrotation associated with adult hypertrophic pyloric stenosis"

Ivanov¹,

Lukanova²,

Popadiin³

et al. 2020

Arch Balk Med Union

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“…In addition, LA and LV remodeling increase the risk of developing significant (i.e. ≥ moderate) functional mitral regurgitation, which has been reported in up to 40-50% of CRT recipients [26,27]. With further disease progression, impaired LV relaxation and LA dysfunction cause elevated filling pressure, which is transmitted retrogradely to the pulmonary venous system, capillaries and arteries, leading to postcapillary pulmonary hypertension [28].…”

Section: Cardiac Remodeling In Crt Candidatesmentioning

confidence: 99%

Prognostic implications of staging cardiac remodeling in patients undergoing cardiac resynchronization therapy

Stassen

Khidir

Galloo

et al. 2022

International Journal of Cardiology

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Effect of Functional Mitral Regurgitation on Outcome in Patients Receiving Cardiac Resynchronization Therapy for Heart Failure

Cited by 31 publications

References 29 publications

Clinical implications of left atrial reverse remodelling after cardiac resynchronization therapy

Clinical implications of left atrial reverse remodelling after cardiac resynchronization therapy

"Surgical approach in a patient with intestinal malrotation associated with adult hypertrophic pyloric stenosis"

Prognostic implications of staging cardiac remodeling in patients undergoing cardiac resynchronization therapy

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