Time course of secondary mitral regurgitation in patients with heart failure receiving cardiac resynchronization therapy: Impact on long-term outcome beyond left ventricular reverse remodelling

Binda, Camille; Menet, Aymeric; Appert, Ludovic; Ennezat, Pierre‐Vladimir; Delelis, François; Castel, Anne-Laure; Goffic, Caroline Le; Guyomar, Yves; Ringlé, Anne; Guerbaaï, Raphaëlle-Ashley; Graux, P; Tribouilloy, Christophe; Maréchaux, Sylvestre

doi:10.1016/j.acvd.2017.05.009

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…Forty‐two studies fulfilled the search criteria (Supporting Information, Table ) 5,7–47 . Two of them evaluated exclusively AR, 46,47 and two other studies assessed AR together with RR 8,9 .…”

Section: Resultsmentioning

confidence: 99%

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

et al. 2021

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Aims Reverse remodelling (RR) is the recovery from left ventricular (LV) dilatation and dysfunction. Many arbitrary criteria for RR have been proposed. We searched the criteria with the strongest prognostic yield for the hard endpoint of cardiovascular death. Methods and resultsWe performed a systematic literature search of diagnostic criteria for RR. We evaluated their prognostic significance in a cohort of 927 patients with LV ejection fraction (LVEF) < 50% undergoing two echocardiograms within 12 ± 2 months. These patients were followed for a median of 2.8 years (interquartile interval 1.3-4.9) after the second echocardiogram, recording 123 cardiovascular deaths. Two prognostic models were defined. Model 1 included age, LVEF, N-terminal pro-B-type natriuretic peptide, ischaemic aetiology, cardiac resynchronization therapy, estimated glomerular filtration rate, New York Heart Association, and LV end-systolic volume (LVESV) index, and Model 2 the validated Cardiac and Comorbid Conditions Heart Failure score. We identified 25 criteria for RR, the most used being LVESV reduction ≥15% (12 studies out of 42). In the whole cohort, two criteria proved particularly effective in risk reclassification over Model 1 and Model 2. These criteria were (i) LVEF increase >10 U and (ii) LVEF increase ≥1 category [severe (LVEF ≤ 30%), moderate (LVEF 31-40%), mild LV dysfunction (LVEF 41-55%), and normal LV function (LVEF ≥ 56%)]. The same two criteria yielded independent prognostic significance and improved risk reclassification even in patients with more severe systolic dysfunction, namely, those with LVEF < 40% or LVEF ≤ 35%. Furthermore, LVEF increase >10 U and LVEF increase ≥1 category displayed a greater prognostic value than LVESV reduction ≥15%, both in the whole cohort and in the subgroups with LVEF < 40% or LVEF ≤ 35%. For example, LVEF increase >10 U independently predicted cardiovascular death over Model 1 and LVESV reduction ≥15% (hazard ratio 0.40, 95% confidence interval 0.18-0.90, P = 0.026), while LVESV reduction ≥15% did not independently predict cardiovascular death (P = 0.112). Conclusions Left ventricular ejection fraction increase >10 U and LVEF increase ≥1 category are stronger predictors of cardiovascular death than the most commonly used criterion for RR, namely, LVESV reduction ≥15%.

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Section: Resultsmentioning

confidence: 99%

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

et al. 2021

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“…Despite improvement in clinical status and NYHA class, the echocardiography results did not meet our expectations. [1][2][3][4] Due to limited number of patients the results were not divided according to the etiology of CHF.…”

Section: Discussionmentioning

confidence: 99%

Gender differences in response to CRTD therapy in patients with valvular regurgitation

Mance

Bitunjac

Matasić

et al. 2019

Cardiologia Croatica

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“…Significant mitral regurgitation (MR) was considered if effective regurgitant orifice area (EROA) was ≥ 10 mm². 9 Significant tricuspid regurgitation (TR) was considered if ≥ moderate to severe. 10 To assess the interobserver variability of RAVI, stored echocardiograms from 20 randomly selected patients were separately studied by two readers (S.M and A.A), during two reading sessions at 1 month interval.…”

Section: Methodsmentioning

confidence: 99%

Impact of Increased Right Atrial Size on Long-Term Mortality in Patients With Heart Failure Receiving Cardiac Resynchronization Therapy

Altes

Appert

Delelis

et al. 2019

The American Journal of Cardiology

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Time course of secondary mitral regurgitation in patients with heart failure receiving cardiac resynchronization therapy: Impact on long-term outcome beyond left ventricular reverse remodelling

Abstract: Significant secondary MR despite CRT provides important prognostic information beyond LV reverse remodelling. Further studies are needed to evaluate the potential role of new percutaneous procedures for mitral valve repair in improving outcome in these very high-risk patients.

Cited by 9 publications

References 18 publications

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

Gender differences in response to CRTD therapy in patients with valvular regurgitation

Impact of Increased Right Atrial Size on Long-Term Mortality in Patients With Heart Failure Receiving Cardiac Resynchronization Therapy

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