PMID- 30131107
OWN - NLM
STAT- MEDLINE
DCOM- 20190821
LR  - 20190821
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 122
IP  - 8
DP  - 2018 Oct 15
TI  - Relation Between Pulmonary Venous Flow and Left Atrial Pressure During 
      Percutaneous Mitral Valve Repair With the MitraClip.
PG  - 1379-1386
LID - S0002-9149(18)31414-0 [pii]
LID - 10.1016/j.amjcard.2018.06.047 [doi]
AB  - Pulmonary venous (PV) flow may provide valuable information in terms of the 
      severity of mitral regurgitation and left atrial (LA) pressure. We sought to find 
      PV flow determinants of LA pressure during MitraClip procedure. We analyzed 575 
      PV flows in 290 patients using transesophageal echocardiography before and after 
      MitraClip procedure. We measured peak systolic velocity (Sv), diastolic velocity 
      (Dv), systolic velocity time integral (Svti), diastolic velocity time integral 
      (Dvti), and those systolic to diastolic ratio as PV flow parameters. Systolic PV 
      flow velocity was lower than diastolic PV flow velocity before the procedure, but 
      systolic PV flow velocity markedly increased after the procedure. Peak Sv/Dv 
      ratio and Svti/Dvti ratio after the procedure were significantly higher than 
      those before the procedure (peak Sv/Dv; 1.06 [inter-quartile range (IQR) 0.73 to 
      1.34] vs 0.32 [IQR 0.03 to 0.55], p <0.001, Svti/Dvti; 1.06 [IQR 0.76 to 1.61] vs 
      0.26 [IQR 0.02 to 0.51], p <0.001). Peak Sv/Dv ratio and Svti/Dvti ratio were 
      negatively correlated with mean LA pressure and LA pressure V wave, respectively 
      (peak Sv/Dv ratio; r = -0.50 and r = -0.59, Svti/Dvti ratio; r = -0.47 and r = 
      -0.58, p <0.001). In receiver operating characteristics curve assessing the 
      ability of PV flow to predict mean LA pressure >/=20 mm Hg after the successful 
      procedure, the area under the curve of peak Sv/Dv ratio was 0.76 (p <0.001). Peak 
      Sv/Dv ratio <0.98 best predicted LA pressure >/=20 mm Hg with 77% sensitivity and 
      71% specificity. In conclusion, systolic PV flow velocity immediately increased 
      in response to mitral regurgitation reduction during MitraClip procedure. PV flow 
      velocity, specifically systolic to diastolic ratio, was useful to evaluate 
      invasively determined LA pressure.
CI  - Copyright (c) 2018 Elsevier Ltd. All rights reserved.
FAU - Ikenaga, Hiroki
AU  - Ikenaga H
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Hayashi, Atsushi
AU  - Hayashi A
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Nagaura, Takafumi
AU  - Nagaura T
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Yamaguchi, Satoshi
AU  - Yamaguchi S
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Yoshida, Jun
AU  - Yoshida J
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Rader, Florian
AU  - Rader F
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Siegel, Robert J
AU  - Siegel RJ
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Kar, Saibal
AU  - Kar S
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Shiota, Takahiro
AU  - Shiota T
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. 
      Electronic address: ShiotaT@cshs.org.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20180725
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Pressure/*physiology
MH  - Echocardiography, Transesophageal
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Mitral Valve Insufficiency/diagnostic imaging/physiopathology/*surgery
MH  - Pulmonary Circulation/*physiology
MH  - Registries
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2018/08/23 06:00
MHDA- 2019/08/23 06:00
CRDT- 2018/08/23 06:00
PHST- 2018/05/18 00:00 [received]
PHST- 2018/06/19 00:00 [revised]
PHST- 2018/06/26 00:00 [accepted]
PHST- 2018/08/23 06:00 [pubmed]
PHST- 2019/08/23 06:00 [medline]
PHST- 2018/08/23 06:00 [entrez]
AID - S0002-9149(18)31414-0 [pii]
AID - 10.1016/j.amjcard.2018.06.047 [doi]
PST - ppublish
SO  - Am J Cardiol. 2018 Oct 15;122(8):1379-1386. doi: 10.1016/j.amjcard.2018.06.047. 
      Epub 2018 Jul 25.