TY - JOUR
T1 - Magnetic resonance imaging assessment of reverse left ventricular remodeling late after restrictive mitral annuloplasty in early stages of dilated cardiomyopathy
AU - Westenberg, Jos J.M.
AU - Braun, Jerry
AU - Van de Veire, Nico R.
AU - Klautz, Robert J.M.
AU - Versteegh, Michel I.M.
AU - Roes, Stijntje D.
AU - van der Geest, Rob J.
AU - de Roos, Albert
AU - van der Wall, Ernst E.
AU - Reiber, Johan H.C.
AU - Bax, Jeroen J.
AU - Dion, Robert A.E.
PY - 2008/6
Y1 - 2008/6
N2 - Objective: Magnetic resonance imaging was used to evaluate left ventricular reverse remodeling at long-term follow-up (3-4 years) after restrictive mitral annuloplasty in patients with early stages of nonischemic, dilated cardiomyopathy, and severe mitral regurgitation. Methods: Twenty-two selected patients (eligible to undergo magnetic resonance imaging) with mild to moderate heart failure (mean New York Heart Association class 2.2 ± 0.4), dilated cardiomyopathy (left ventricular ejection fraction 37% ± 5%, left ventricular end-diastolic volume 215 ± 34 mL), and severe mitral regurgitation (grade 3-4+) underwent restrictive mitral annuloplasty. Magnetic resonance imaging was performed 1 week before surgery and repeated after 3 to 4 years. Results: There was no hospital mortality or major morbidity. Two patients died during follow-up (9%), and 2 patients could not undergo repeat magnetic resonance imaging because of comorbidity. New York Heart Association class improved from 2.2 ± 0.4 to 1.2 ± 0.4 (P < .05). Mitral regurgitation was minimal at late echocardiographic follow-up. There were significant decreases in indexed (to body surface area) left atrial end-systolic volume (from 84 ± 20 mL/m2 to 68 ± 12 mL/m2, P < .01), left ventricular end-systolic volume (from 42 ± 14 mL/m2 to 31 ± 12 mL/m2, P < .01), left ventricular end-diastolic volume (from 110 ± 18 mL/m2 to 80 ± 17 mL/m2, P < .01), and left ventricular mass (from 76 ± 21 g/m2 to 66 ± 12 g/m2, P = .03). Forward left ventricular ejection fraction improved from 37% ± 5% to 55% ± 10% (P < .01). Indexed left atrial end-diastolic volume did not show a significant decrease (from 48 ± 16 mL/m2 to 44 ± 10 mL/m2, P = .15). Conclusion: Magnetic resonance imaging confirms sustained significant reverse left atrial and ventricular remodeling at late (3-4 years) follow-up in patients with nonischemic, dilated cardiomyopathy, and mild to moderate heart failure after restrictive mitral annuloplasty.
AB - Objective: Magnetic resonance imaging was used to evaluate left ventricular reverse remodeling at long-term follow-up (3-4 years) after restrictive mitral annuloplasty in patients with early stages of nonischemic, dilated cardiomyopathy, and severe mitral regurgitation. Methods: Twenty-two selected patients (eligible to undergo magnetic resonance imaging) with mild to moderate heart failure (mean New York Heart Association class 2.2 ± 0.4), dilated cardiomyopathy (left ventricular ejection fraction 37% ± 5%, left ventricular end-diastolic volume 215 ± 34 mL), and severe mitral regurgitation (grade 3-4+) underwent restrictive mitral annuloplasty. Magnetic resonance imaging was performed 1 week before surgery and repeated after 3 to 4 years. Results: There was no hospital mortality or major morbidity. Two patients died during follow-up (9%), and 2 patients could not undergo repeat magnetic resonance imaging because of comorbidity. New York Heart Association class improved from 2.2 ± 0.4 to 1.2 ± 0.4 (P < .05). Mitral regurgitation was minimal at late echocardiographic follow-up. There were significant decreases in indexed (to body surface area) left atrial end-systolic volume (from 84 ± 20 mL/m2 to 68 ± 12 mL/m2, P < .01), left ventricular end-systolic volume (from 42 ± 14 mL/m2 to 31 ± 12 mL/m2, P < .01), left ventricular end-diastolic volume (from 110 ± 18 mL/m2 to 80 ± 17 mL/m2, P < .01), and left ventricular mass (from 76 ± 21 g/m2 to 66 ± 12 g/m2, P = .03). Forward left ventricular ejection fraction improved from 37% ± 5% to 55% ± 10% (P < .01). Indexed left atrial end-diastolic volume did not show a significant decrease (from 48 ± 16 mL/m2 to 44 ± 10 mL/m2, P = .15). Conclusion: Magnetic resonance imaging confirms sustained significant reverse left atrial and ventricular remodeling at late (3-4 years) follow-up in patients with nonischemic, dilated cardiomyopathy, and mild to moderate heart failure after restrictive mitral annuloplasty.
UR - http://www.scopus.com/inward/record.url?scp=44649166282&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=44649166282&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/18544363
U2 - https://doi.org/10.1016/j.jtcvs.2007.10.021
DO - https://doi.org/10.1016/j.jtcvs.2007.10.021
M3 - Article
C2 - 18544363
SN - 0022-5223
VL - 135
SP - 1247
EP - 1253
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -