Polish archives of internal medicine · 2021
The function of the heart after successful transcatheter mitral valve repair due to severe functional regurgitation.
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Scisło Piotr, Rdzanek Adam, Pietrasik Arkadiusz, Kochman Janusz, Opolski Grzegorz
Аннотация
INTRODUCTION: The function of the heart after successful transcatheter edge‑to‑edge mitral valve repair (TMVR) remains not fully investigated.
OBJECTIVES: The aim of our study was to assess the direct impact of effective TMVR on the strains of the left atrium (LA), the left ventricle (LV), and the right ventricle (RV) in patients with functional mitral regurgitation due to coronary artery disease or dilated cardiomyopathy.
PATIENTS AND METHODS: Out of a group that successfully underwent TMVR, we selected 28 patients for the analysis. The remodeling of the LA, the LV, and the RV as well as their strains were assessed.
RESULTS: In the short‑term follow‑up, we found a positive change of LA and LV volumes, RV dimensions but not LV ejection fraction. No strain improvement was observed in the pre and post analysis of LV, RV, LA, and LA in phase 3 (contraction phase). We found a deterioration of LA strain in phases 1 (reservoir phase) and 2 (conduit phase) in patients with a history of paroxysmal atrial fibrillation (phase 1, 2.5% [0%-5.47%]; P = 0.01; phase 2, -3.1% [-0.75% to -6.61%]; P = 0.004) and with coronary artery disease (phase 1, 2.2% [-0.82% to 5.47%]; P = 0.049; phase 2, -3.7% [-7.48% to -1.25%]; P = 0.01).
CONCLUSIONS: Our data indicate that no improvement of heart strains can be expected after suc-cessful TMVR in the short‑term follow‑up, and the function of the LA may even deteriorate in some subpopulations.
OBJECTIVES: The aim of our study was to assess the direct impact of effective TMVR on the strains of the left atrium (LA), the left ventricle (LV), and the right ventricle (RV) in patients with functional mitral regurgitation due to coronary artery disease or dilated cardiomyopathy.
PATIENTS AND METHODS: Out of a group that successfully underwent TMVR, we selected 28 patients for the analysis. The remodeling of the LA, the LV, and the RV as well as their strains were assessed.
RESULTS: In the short‑term follow‑up, we found a positive change of LA and LV volumes, RV dimensions but not LV ejection fraction. No strain improvement was observed in the pre and post analysis of LV, RV, LA, and LA in phase 3 (contraction phase). We found a deterioration of LA strain in phases 1 (reservoir phase) and 2 (conduit phase) in patients with a history of paroxysmal atrial fibrillation (phase 1, 2.5% [0%-5.47%]; P = 0.01; phase 2, -3.1% [-0.75% to -6.61%]; P = 0.004) and with coronary artery disease (phase 1, 2.2% [-0.82% to 5.47%]; P = 0.049; phase 2, -3.7% [-7.48% to -1.25%]; P = 0.01).
CONCLUSIONS: Our data indicate that no improvement of heart strains can be expected after suc-cessful TMVR in the short‑term follow‑up, and the function of the LA may even deteriorate in some subpopulations.