PMID- 28931437
OWN - NLM
STAT- MEDLINE
DCOM- 20180619
LR  - 20181113
IS  - 2047-783X (Electronic)
IS  - 0949-2321 (Print)
IS  - 0949-2321 (Linking)
VI  - 22
IP  - 1
DP  - 2017 Sep 20
TI  - Acute reverse annular remodeling during MitraClip((R)) therapy predicts improved 
      clinical outcome in heart failure patients: a 3D echocardiography study.
PG  - 33
LID - 10.1186/s40001-017-0273-x [doi]
LID - 33
AB  - BACKGROUND: Transcatheter mitral valve repair (TMVR) has been shown to have acute 
      effects on mitral valve geometry in patients with functional mitral regurgitation 
      (FMR). This study investigates the impact of MitraClip((R)) therapy-induced annular 
      remodeling on clinical outcome and mitral regurgitation in heart failure 
      patients. METHODS: TMVR was performed successfully in 45 patients with FMR. In 
      this study, mitral valve datasets were obtained before and directly after 
      MitraClip((R)) implantation using three-dimensional (3D) transesophageal 
      echocardiography, and were analyzed offline retrospectively using dedicated 3D 
      reconstruction software. Patients underwent clinical and echocardiographic 
      evaluation at baseline and after 6 months. At follow-up, the patients were 
      allocated into two groups according to their improvement in New York Heart 
      Association (NYHA) functional class: a Low Responder group with DeltaNYHA <1.5 
      (n = 25); and a High Responder group with DeltaNYHA >/=1.5 (n = 20). RESULTS: At 
      6-month follow-up, data analysis revealed that while mitral regurgitation was 
      reduced significantly in both groups, only the High Responder group had 
      experienced significant downsizing of the 3D circumference (137 +/- 14 mm to 
      126 +/- 13 mm; p < 0.01) and the anterior-to-posterior diameter (33 +/- 5 mm to 
      29 +/- 4 mm; p < 0.01) of the mitral annulus during the intervention. Furthermore, 
      only the High Responder group with reverse annular remodeling as shown had 
      substantial advances in quality of life (Minnesota living with heart failure 
      questionnaire: 55 +/- 10 to 34 +/- 14 points; p < 0.01) and functional status (6-min 
      walk distance: 290 +/- 104 m to 462 +/- 111 m; p = 0.07). CONCLUSION: Our study 
      demonstrates that instantaneous left ventricular annular remodeling during 
      MitraClip((R)) implantation is associated with improved clinical outcome of heart 
      failure patients with functional mitral regurgitation. Trial registration The 
      study was approved by the local ethics committee (Study Number 4497R, 
      Registration ID: 2013121585). TRIAL REGISTRATION: NCT02033811 Retrospectively 
      registered January 9, 2014.
FAU - Herbrand, Theresa
AU  - Herbrand T
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
FAU - Eschenhagen, Silke
AU  - Eschenhagen S
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
FAU - Zeus, Tobias
AU  - Zeus T
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
FAU - Kehmeier, Eva
AU  - Kehmeier E
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
FAU - Hellhammer, Katharina
AU  - Hellhammer K
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
FAU - Veulemans, Verena
AU  - Veulemans V
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
FAU - Kelm, Malte
AU  - Kelm M
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
FAU - Balzer, Jan
AU  - Balzer J
AD  - Department of Medicine, Division of Cardiology, Pneumology, and Angiology, 
      University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. 
      Dr.Balzer@uhlandpraxen.de.
LA  - eng
SI  - ClinicalTrials.gov/NCT02033811
PT  - Clinical Trial
PT  - Journal Article
DEP - 20170920
PL  - England
TA  - Eur J Med Res
JT  - European journal of medical research
JID - 9517857
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Echocardiography/methods
MH  - Female
MH  - Heart Failure/diagnostic imaging/etiology/*surgery
MH  - Heart Valve Prosthesis/*adverse effects
MH  - Heart Valve Prosthesis Implantation/adverse effects/instrumentation/*methods
MH  - Humans
MH  - Imaging, Three-Dimensional/methods
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Annuloplasty/adverse effects/instrumentation/*methods
MH  - Mitral Valve Insufficiency/complications/diagnostic imaging/*surgery
PMC - PMC5607606
OTO - NOTNLM
OT  - Echocardiography
OT  - MitraClip(R)
OT  - Mitral valve insufficiency
OT  - Remodeling
OT  - TMVR
OT  - Three-dimensional
EDAT- 2017/09/22 06:00
MHDA- 2018/06/21 06:00
PMCR- 2017/09/20
CRDT- 2017/09/22 06:00
PHST- 2017/01/02 00:00 [received]
PHST- 2017/09/07 00:00 [accepted]
PHST- 2017/09/22 06:00 [entrez]
PHST- 2017/09/22 06:00 [pubmed]
PHST- 2018/06/21 06:00 [medline]
PHST- 2017/09/20 00:00 [pmc-release]
AID - 10.1186/s40001-017-0273-x [pii]
AID - 273 [pii]
AID - 10.1186/s40001-017-0273-x [doi]
PST - epublish
SO  - Eur J Med Res. 2017 Sep 20;22(1):33. doi: 10.1186/s40001-017-0273-x.