title: Cardiac remodeling following percutaneous mitral valve repair - initial results assessed by cardiovascular magnetic resonance imaging.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Cardiology, University Heart Center, Hamburg.
authors.forename: U K
authors.initials: UK
authors.lastname: Radunski
authors.affiliation: Cardiology, Rigshospitalet, Copenhagen.
authors.forename: O
authors.initials: O
authors.lastname: Franzen
authors.affiliation: Cardiology, Klinikum Dortmund.
authors.forename: A
authors.initials: A
authors.lastname: Barmeyer
authors.affiliation: Cardiology, University Heart Center, Hamburg.
authors.forename: M
authors.initials: M
authors.lastname: Lange
authors.affiliation: Radiology, University Medical Center Hamburg-Eppendorf, Hamburg.
authors.forename: G
authors.initials: G
authors.lastname: Lund
authors.affiliation: Cardiology, University Heart Center, Hamburg.
authors.forename: V
authors.initials: V
authors.lastname: Rudolph
authors.affiliation: Cardiology, University Heart Center, Hamburg.
authors.forename: M
authors.initials: M
authors.lastname: Schlüter
authors.affiliation: Radiology, University Medical Center Hamburg-Eppendorf, Hamburg.
authors.forename: G
authors.initials: G
authors.lastname: Adam
authors.affiliation: Cardiovascular Surgery, University Heart Center, Hamburg.
authors.forename: H
authors.initials: H
authors.lastname: Reichenspurner
authors.affiliation: Cardiology, University Heart Center, Hamburg.
authors.forename: S
authors.initials: S
authors.lastname: Blankenberg
authors.affiliation: Cardiology, University Heart Center, Hamburg.
authors.forename: S
authors.initials: S
authors.lastname: Baldus
authors.affiliation: Cardiology, University Heart Center, Hamburg.
authors.forename: K
authors.initials: K
authors.lastname: Muellerleile
mesh_terms: D016477:Artifacts; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods*; D002306:Cardiac Volume / Q000502:physiology; D004452:Echocardiography; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D013525:Surgical Instruments; D020257:Ventricular Remodeling / Q000502:physiology*