Prevalence and severity of mitral regurgitation in chronic systolic heart failure

Robbins, Joel D.; Maniar, Parimal B.; Cotts, William; Parker, Michele; Bonow, Robert O.; Gheorghiade, Mihai

doi:10.1016/s0002-9149(02)03172-7

Cited by 155 publications

(96 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The association between mitral insufficiency and death or hospitalization for heart failure is consistent across different categories of the mitral insufficiency variable and appears to increase with increasing severity of mitral insufficiency. Several recent studies have found similar results, with mitral insufficiency being associated with poorer long-term outcomes, including more symptoms (8,12) and death (8,(9)(10)(11). The incidence of mitral insufficiency in these studies was higher (43% to 70%) than in the current study of SOLVD trial patients (15%).…”

Section: Discussionsupporting

confidence: 80%

See 1 more Smart Citation

Mitral insufficiency and morbidity and mortality in left ventricular dysfunction

Baskett

Exner

Hirsch

et al. 2007

Canadian Journal of Cardiology

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 80%

“…Other recent studies have demonstrated adverse outcomes associated with mitral insufficiency in patients with left ventricular dysfunction (9)(10)(11)(12).…”

mentioning

confidence: 98%

Mitral insufficiency and morbidity and mortality in left ventricular dysfunction

Baskett

Exner

Hirsch

et al. 2007

Canadian Journal of Cardiology

View full text Add to dashboard Cite

“…It is clear that percutaneous or other less invasive therapies are needed to address a population of individuals with FMR/IMR who are not ideal surgical candidates but who likely would benefit from a reduction in their MR. [11][12][13] Currently, multiple percutaneous approaches to treat MR are under development. These can be broadly categorized into leaflet (or "edge-to-edge") approaches for patients with adequate leaflet proximity (and not generally with FMR/IMR), 14,15 coronary sinus "annuloplasty" approaches for the treatment of FMR or IMR, 16 -20 direct annular plication approaches simulating a true surgical annuloplasty, and direct left ventricular remodeling using a transventricular device.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Septal Sinus Shortening

et al. 2006

View full text Add to dashboard Cite

Background-The septal-to-lateral (SL) mitral annular diameter is increased in functional mitral regurgitation (MR). We describe a novel percutaneous technique (the percutaneous septal sinus shortening system) that ameliorates functional MR in an ovine model. Methods and Results-Sheep underwent rapid right ventricular pacing to obtain moderate to severe functional MR with SL enlargement. The percutaneous septal sinus shortening system was placed via standard interventional techniques consisting of a bridge (suture) element between interatrial septal wall and great cardiac vein anchors. Through progressive tensioning of the bridge element, direct SL shortening was achieved. Sheep underwent short-term (nϭ19) and long-term (nϭ4) evaluation after device implantation. In short-term studies, SL diameter decreased an average of 24% (32.5Ϯ3.5 to 24.6Ϯ2.4 mm; PϽ0.001), and MR grade significantly improved (2.1Ϯ0.6 to 0.4Ϯ0.4; PϽ0.001).Despite continued rapid pacing, chronic device implantation resulted in durable SL shortening (30.4Ϯ1.9 mm before implantation to 25.3Ϯ0.8 mm at 30 days; Pϭ0.01) and MR reduction (1.8Ϯ0.5 before implantation to 0.2Ϯ0.1 at 30 days; Pϭ0.01). Increased cardiac output, decreased wedge pressure, and decreased brain natriuretic peptide levels were observed in animals undergoing long-term device implantation. Conclusions-The percutaneous septal sinus shortening system is effective in ameliorating functional MR in an ovine tachycardia model. The procedure, which uses standard catheter techniques, can be deployed largely under fluoroscopic guidance. The unique bridge element appears durable and allows direct and precise SL shortening to a diameter optimal for MR reduction.

show abstract

“…2,3 MR severity is an independent predictor of prognosis in patients with ischemic heart disease, 4 -6 even when MR is moderate or mild, 2 particularly in the presence of congestive failure. 2,7 When MR is severe, prognosis is poor, 8 even when asymptomatic. 4,9 MR as a consequence of ischemic disease most often occurs despite the presence of structurally normal mitral valve leaflets.…”

Section: Itral Regurgitation (Mr) Is Common After Myocardial Infarcmentioning

confidence: 99%

Percutaneous Transvenous Mitral Annuloplasty

et al. 2006

View full text Add to dashboard Cite

Background-Mitral annuloplasty is the most common surgical procedure performed for ischemic mitral regurgitation (MR). Surgical mitral annuloplasty is limited by morbidity, mortality, and MR recurrence. We evaluated the safety and feasibility of a transvenous catheter-delivered implantable device to provide a percutaneous alternative to surgical mitral annuloplasty. Methods and Results-Five patients with chronic ischemic MR underwent percutaneous transvenous implantation of an annuloplasty device in the coronary sinus. Implantation was successful in 4 patients. Baseline MR in the entire group was grade 3.0Ϯ0.7 and was reduced to grade 1.6Ϯ1.1 at the last postimplantation visit when the device was intact or the last postprocedural visit in the patient in whom the device was not successfully implanted. Separation of the bridge section of the device occurred in 3 of 4 implanted devices and was detected at 28 to 81 days after implantation. There were no postprocedural device-related complications. Conclusions-Percutaneous

show abstract

Prevalence and severity of mitral regurgitation in chronic systolic heart failure

Cited by 155 publications

References 16 publications

Mitral insufficiency and morbidity and mortality in left ventricular dysfunction

Mitral insufficiency and morbidity and mortality in left ventricular dysfunction

Percutaneous Septal Sinus Shortening

Percutaneous Transvenous Mitral Annuloplasty

Contact Info

Product

Resources

About