title: MRI to evaluate left atrial and ventricular reverse remodeling after restrictive mitral annuloplasty in dilated cardiomyopathy.
abstract: BACKGROUND
  Data on reverse remodeling of the left atrium (LA) and left ventricle (LV) after restrictive annuloplasty in patients with dilated cardiomyopathy are scarce, and follow-up studies are performed with echocardiography.
  
  
  RESULTS
  Twenty patients with dilated cardiomyopathy and severe mitral regurgitation selected for restrictive mitral annuloplasty underwent serial MRI studies (within 1 week before surgery, and 2 months [n =18] and 1 year [n =13] after surgery). Early mortality was 10%; all patients were free from endocarditis and thromboembolism. New York Heart Association class improved from 3.2+/-0.4 to 1.2+/-0.9. Only 1 patient developed recurrent severe mitral regurgitation during follow-up and it was re-repaired. LA end-systolic volumes decreased significantly over time (from 165+/-48 mL to 109+/-23 mL to 111+/-28 mL; P < 0.01), as did LA end-diastolic volumes (from 92+/-32 mL to 71+/-22 mL to 75+/-17 mL; P = 0.01). LV end-diastolic volumes decreased significantly (from 244+/-56 mL to 184+/-54 mL to 195+/-67 mL; P < 0.01), whereas end-systolic volumes did not change significantly. LV ejection fraction increased significantly (from 35+/-8% to 46+/-13% to 46+/-15%; P < 0.01) and LV mass decreased significantly (from 150+/-43 grams to 132+/-39 grams to 136+/-33 grams; P = 0.02).
  
  
  CONCLUSIONS
  Restrictive annuloplasty in patients with dilated cardiomyopathy yielded excellent clinical results associated with significant LA and LV reverse remodeling over time as demonstrated by MRI.
authors.affiliation: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. j.j.m.westenberg@lumc.nl
authors.forename: Jos J M
authors.initials: JJ
authors.lastname: Westenberg
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van der Geest
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: Michel I M
authors.initials: MI
authors.lastname: Versteegh
authors.forename: Jerry
authors.initials: J
authors.lastname: Braun
authors.forename: Joost
authors.initials: J
authors.lastname: Doornbos
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Robert A E
authors.initials: RA
authors.lastname: Dion
authors.forename: Johan H C
authors.initials: JH
authors.lastname: Reiber
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology*; D006333:Heart Failure / Q000209:etiology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015588:Observer Variation; D009929:Organ Size; D019736:Prostheses and Implants; D013318:Stroke Volume; D016019:Survival Analysis; D014463:Ultrasonography; D020257:Ventricular Remodeling