title: Percutaneous mitral valve repair in the initial EVEREST cohort: evidence of reverse left ventricular remodeling.
abstract: BACKGROUND
  Percutaneous repair of mitral regurgitation (MR) permits examination of the effect of MR reduction without surgery and cardiopulmonary bypass on left ventricular (LV) dimensions and function. The goal of this analysis was to determine the extent of reverse remodeling at 12 months after successful percutaneous reduction of MR with the MitraClip device.
  
  
  RESULTS
  Of 64 patients with 3 and 4+ MR who achieved acute procedural success after treatment with the MitraClip device, 49 patients had moderate or less MR at 12-month follow-up. Their baseline and 12-month echocardiograms were compared between the group with and without LV dysfunction. In patients with persistent MR reduction and pre-existing LV dysfunction, there was a reduction in LV wall stress, reduced LV end-diastolic volume, LV end-systolic volume and increase in LV ejection fraction in contrast to those with normal baseline LV function, who showed reduction in LV end-diastolic volume, LV wall stress, no change in LV end-systolic volume, and a fall in LV ejection fraction.
  
  
  CONCLUSIONS
  Patients with pre-existing LV dysfunction demonstrate reverse remodeling and improved LV ejection fraction after percutaneous mitral valve repair.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00209339, NCT00209274.
authors: Division of Cardiology, University of California at San Francisco, San Francisco, CA 94143, USA. foster@medicine.ucsf.edu
authors: Elyse
authors: E
authors: Foster
authors: Damon
authors: D
authors: Kwan
authors: Ted
authors: T
authors: Feldman
authors: Neil J
authors: NJ
authors: Weissman
authors: Paul A
authors: PA
authors: Grayburn
authors: Allan
authors: A
authors: Schwartz
authors: Jason H
authors: JH
authors: Rogers
authors: Saibal
authors: S
authors: Kar
authors: Michael J
authors: MJ
authors: Rinaldi
authors: Peter S
authors: PS
authors: Fail
authors: James
authors: J
authors: Hermiller
authors: Patrick L
authors: PL
authors: Whitlow
authors: Howard C
authors: HC
authors: Herrmann
authors: D Scott
authors: DS
authors: Lim
authors: Donald D
authors: DD
authors: Glower
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002170:Canada; D006328:Cardiac Catheterization / Q000295:instrumentation; D062906:Cardiac Catheters; D004867:Equipment Design; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D058386:Mitral Valve Annuloplasty / Q000295:instrumentation; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014481:United States; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: echocardiography; left ventricular dysfunction; mitral regurgitation; percutaneous mitral valve repair; reverse left ventricular remodeling