scholarly journals RESERVOIR FUNCTION OF LEFT ATRIUM IS IMPAIRED IN PATIENTS WITH HEART FAILURE AND SEVERE MITRAL REGURGITATION

2011 ◽  
Vol 57 (14) ◽  
pp. E1403
Author(s):  
Tomohiro Hayashi ◽  
Makoto Amaki ◽  
Akira Funada ◽  
Hiroyuki Takahama ◽  
Takuya Hasegawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Severe Mitral Regurgitation ◽  
Reservoir Function ◽  
Patients With Heart Failure

P5571MitraClip implantation impairs functional echocardiographic parameters of the left atrium in patients with moderate to severe mitral regurgitation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Meindl ◽  
M Hamerle ◽  
D Rogalski ◽  
M Paulus ◽  
C Schach ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Left Atrium ◽  
Longitudinal Strain ◽  
Structural Changes ◽  
Severe Mitral Regurgitation ◽  
Functional Parameters ◽  
Reservoir Function

Abstract Background MitraClip implantation induces hemodynamic unloading and reverse remodeling of the left atrium (LA) and the left ventricle (LV). However little data exist concerning the effects of MitraClip implantation on LA and LV strain reflecting LA and LV function. Methods and results From August 2017 to September 2018 62 patients with moderate to severe mitral regurgitation were prospectively enrolled in our single-center RETORT-MR trial (Regensburg Trial on TMVR Techniques in Mitral Regurgitation). All included patients were treated using the MitraClip procedure. Two dimensional speckle tracking echocardiography (2DSTE) of the LA as well as of the LV could be performed in 35 patients with follow-up 2DSTE at four weeks and/or three months after MitraClip implantation. In 25.7% of patients primary mitral regurgitation was present (n=9) and in 74.3% of subjects a secondary entity of mitral regurgitation had been diagnosed (n=26). 57.1% of patients (n=20) suffered from heart failure with preserved ejection fraction (HFpEF) and 42.9% of patients (n=15) had heart failure with reduced ejection fraction (HFrEF). Global longitudinal strain (GLS) was reduced at baseline (−15.3%), at four-week (−14.5%, n=27) and at three-month follow-up (−13.9%, n=28) with no statistically significant differences indicating a sustained mechanical impairment of LV. In contrast significant deterioration was observed in the peak atrial longitudinal strain (PALS) representing LA reservoir function (15.3% at baseline vs. 11.8% at four-week follow-up, n=25, p=0.015 and 16.0% at baseline vs. 13.2% at three-month follow-up, n=25, p=0.03). Similarly to LA reservoir function LA booster function indicating left atrial active contraction was significantly reduced after MitraClip implantation (12.5% at baseline vs. 8.0% at four-week follow-up, n=10, p=0.028). Contrary to LA functional parameters LA size did not change significantly after MitraClip implantation (LA volume index at baseline 74.5 ml/m2 vs. 70.1 ml/m2 at four-week follow-up, n=27, p=0.489). Conclusion The present study revealed a deterioration of LA functional parameters (LA reservoir and LA booster function) after MitraClip insertion. It is known that severe mitral regurgitation can cause structural changes of the LA such as fibrosis. MitraClip insertion leads to a significant reduction of regurgitant volumes but structural changes of the LA may not be reversible. In addition MitraClip implantation increases afterload in the LA potentially explaining the observed deterioration of LA functional parameters. Acknowledgement/Funding None

The Novel Use of Mitraclip in a Patient with Combined Multiple Myeloma and Heart Failure with Severe Mitral Regurgitation

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Abu Ghosh Z ◽  
◽  
Beeri R ◽  
Falah B ◽  
Pertz A ◽  
...  
Keyword(s):  
Heart Failure ◽  
Multiple Myeloma ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Severe Mitral Regurgitation ◽  
The Novel ◽  
Valve Repair ◽  
Oncological Treatment ◽  
Patients With Heart Failure

Oncology patients with Heart Failure (HF) and severe Mitral Regurgitation (MR) are often considered to have a prohibitive risk for surgical mitral valve repair/replacement. We describe a patient with active multiple myeloma and significant HF and MR who was treated with MitraClip, which improved symptoms and allowed delivery of optimal oncological treatment.

scholarly journals Value of MitraClip in Reducing Functional Mitral Regurgitation

2019 ◽  
Vol 13 (1) ◽  
pp. 30-34
Author(s):  
Mehmet Ali Elbey ◽  
Luis Augusto Palma Dallan ◽  
Guilherme Ferragut Attizzani ◽  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Current Evidence ◽  
Successful Implementation ◽  
Severe Mitral Regurgitation ◽  
Percutaneous Mitral Valve Repair ◽  
Patients With Heart Failure

Patients with heart failure who have secondary severe mitral regurgitation due to left ventricular dysfunction have a poor prognosis, with high rates of rehospitalization and mortality. Percutaneous mitral valve repair using the MitraClip (Abbott) has been shown to be safe and effective in secondary severe mitral regurgitation with heart failure. The number of MitraClip procedures performed has increased significantly, as recently published large, randomized clinical studies have shown. However, these studies have drawn different conclusions. This review aims to summarize the current evidence for the MitraClip procedure and provide information for its safe and successful implementation, comparing the studies that examined the use of MitraClip versus medical therapy alone or surgical repair for severe secondary mitral regurgitation.

Mid-term results of percutaneous treatment of severe mitral regurgitation with MitraClip in patients with heart failure

2021 ◽  
Vol 20 (2) ◽  
pp. 102-105
Author(s):  
Michaela Červinková ◽  
Jiří Hlaváček ◽  
Petr Vojtíšek ◽  
Martin Kvašňák ◽  
Pavel Červinka
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Percutaneous Treatment ◽  
Severe Mitral Regurgitation ◽  
Patients With Heart Failure ◽  
Mid Term Results

Transcatheter mitral valve replacement

2018 ◽  
pp. 629-638
Author(s):  
Ricardo Boix Garibo ◽  
Mohsin Uzzaman ◽  
Michael Ghosh-Dastidar ◽  
Vinayak Bapat
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Regurgitation ◽  
Common Disease ◽  
Severe Mitral Regurgitation ◽  
Valve Regurgitation ◽  
Number Of Patients ◽  
Transcatheter Mitral Valve Replacement ◽  
Patients With Heart Failure

Mitral valve regurgitation is a common disease affecting a large number of patients with heart failure. It is more prevalent in Europe and North America and predominantly in older ages. It has been estimated that moderate to severe mitral regurgitation will double its prevalence by 2030, affecting more than 4 million people. Mitral regurgitation is the second most common valve disease requiring surgery in Europe.

The Results of the Use of Angiotensin Receptor Inhibitors and Neprilisin in Secondary Functional Mitral Regurgitation in Outpatient Practice

2020 ◽  
Vol 75 (5) ◽  
pp. 514-522
Author(s):  
Alexey S. Ryazanov ◽  
Konstantin I. Kapitonov ◽  
Mariya V. Makarovskaya ◽  
Alexey A. Kudryavtsev
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Effective Area ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Angiotensin Receptor ◽  
Optimal Drug ◽  
Patients With Heart Failure ◽  
Valsartan Group

Background. Morbidity and mortality in patients with functional mitral regurgitation (FMR) remains high, however, no pharmacological therapy has been proven to be effective.Aimsto study the effect of sacubitrile/valsartan and valsartan on functional mitral regurgitation in chronic heart failure.Methods.This double-blind study randomly assigned sacubitrile/valsartan or valsartan in addition to standard drug therapy for heart failure among 100 patients with heart failure with chronic FMR (secondary to left ventricular (LV) dysfunction). The primary endpoint was a change in the effective area of the regurgitation hole during the 12-month follow-up. Secondary endpoints included changes in the volume of regurgitation, the final systolic volume of the left ventricle, the final diastolic volume of the left ventricle, and the area of incomplete closure of the mitral valves.Results.The decrease in the effective area of the regurgitation hole was significantly more pronounced in the sacubitrile/valsartan group than in the valsartan group (0.070.066against0.030.058sm2; p=0.018)in the treatment efficacy analysis, which included 100patients (100%). The regurgitation volume also significantly decreased in the sacubitrile/valsartan group compared to the valsartan group (mean difference:8.4ml; 95%CI, from 13.2 until 1.9;р=0.21). There were no significant differences between the groups regarding changes in the area ofincomplete closure of the mitral valves and LV volumes, with the exception of the index of the final LV diastolic volume (p=0.07).Conclusion.Among patients with secondary FMR, sacubitril/valsartan reduced MR more than valsartan. Thus, angiotensin receptor inhibitors and neprilysin can be considered for optimal drug treatment of patients with heart failure and FMR.

Redistribution of cardiac output during exercise by functional mitral regurgitation in heart failure: compensatory O2 peripheral uptake to delivery failure

2020 ◽  
Vol 319 (1) ◽  
pp. H100-H108
Author(s):  
Marco Guazzi ◽  
Greta Generati ◽  
Barry Borlaug ◽  
Eleonora Alfonzetti ◽  
Tadafumi Sugimoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Gas Exchange ◽  
Mitral Regurgitation ◽  
Functional Mitral Regurgitation ◽  
Functional Evaluation ◽  
Severe Mitral Regurgitation ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Fraction Versus

This is an analysis involving 134 heart failure patients with reduced ejection fraction versus 80 controls investigated during functional evaluation with gas exchange and hemodynamic, addressing the severe mitral regurgitation phenotype and testing the hypothesis that the backward cardiac output redistribution to the lung during exercise impairs delivery and overexpresses peripheral extraction. This information is new and has important implications in the management of heart failure.

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