Radunski U K, Franzen O, Barmeyer A, Lange M, Lund G, Rudolph V, Schlüter M, Adam G, Reichenspurner H, Blankenberg S, Baldus S, Muellerleile K
Cardiology, University Heart Center, Hamburg.
Cardiology, Rigshospitalet, Copenhagen.
Rofo. 2014 Oct;186(10):951-8. doi: 10.1055/s-0034-1366216. Epub 2014 Mar 19.
Percutaneous mitral valve repair with the MitraClip device (Abbott Vascular, Redwood City, California, USA) is a novel therapeutic option in patients with mitral regurgitation. This study evaluated the feasibility of cardiac volume measurements by cardiovascular magnetic resonance imaging (CMR) to assess reverse myocardial remodeling in patients after MitraClip implantation.
12 patients underwent CMR at baseline (BL) before and at 6 months follow-up (FU) after MitraClip implantation. Cine-CMR was performed in short- and long-axes for the assessment of left ventricular (LV), right ventricular (RV) and left atrial (LA) volumes.
Assessment of endocardial contours was not compromised by the device-related artifact. No significant differences in observer variances were observed for LV, RV and LA volume measurements between BL and FU. LV end-diastolic (median 127 [IQR 96 - 150] vs. 112 [86 - 150] ml/m(2); p = 0.03) and LV end-systolic (82 [54 - 91] vs. 69 [48 - 99] ml/m(2); p = 0.03) volume indices decreased significantly from BL to FU. No significant differences were found for RV end-diastolic (94 [75 - 103] vs. 99 [77 - 123] ml/m(2); p = 0.91), RV end-systolic (48 [42 - 80] vs. 51 [40 - 81] ml/m(2); p = 0.48), and LA (87 [55 - 124] vs. 92 [48 - 137] ml/m(2); p = 0.20) volume indices between BL and FU.
CMR enables the assessment of cardiac volumes in patients after MitraClip implantation. Our CMR findings indicate that percutaneous mitral valve repair results in reverse LV but not in RV or LA remodeling.
• Volume measurements by cardiovascular magnetic resonance imaging are feasible following percutaneous mitral valve repair despite device-related artifacts.• A significant reduction of left ventricular volume was found in terms of beneficial, reverse left ventricular remodeling after 6-month follow-up.• No significant reduction was found in right ventricular or left atrial volumes after percutaneous mitral valve repair after 6-month follow-up.
使用MitraClip装置（美国加利福尼亚州红木城雅培血管公司）进行经皮二尖瓣修复是二尖瓣反流患者的一种新型治疗选择。本研究评估了通过心血管磁共振成像（CMR）测量心脏容积以评估MitraClip植入术后患者逆向心肌重构的可行性。
12例患者在MitraClip植入术前基线（BL）和术后6个月随访（FU）时接受了CMR检查。采用短轴和长轴电影CMR评估左心室（LV）、右心室（RV）和左心房（LA）容积。
与装置相关的伪影未影响心内膜轮廓的评估。BL和FU之间LV、RV和LA容积测量的观察者差异无显著差异。LV舒张末期容积指数（中位数127 [四分位间距96 - 150] vs. 112 [86 - 150] ml/m²；p = 0.
