title: Effects of Mitral Annulus Remodeling Following MitraClip Procedure on Reduction of Functional Mitral Regurgitation.
abstract: OBJECTIVE
  The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology.
  
  
  METHODS
  The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area.
  
  
  RESULTS
  The study included 23 patients (age, 65±14 years; 74% men; left ventricular ejection fraction, 31%±13%; systolic pulmonary artery pressure, 47±10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm2±0.04 cm2(P<.0005), from a baseline of 0.49 cm2±0.09 cm2. Anteroposterior diameter decreased by 3.14 mm±1.01 mm (P<.0005) from a baseline of 28.27 mm±4.9 mm, with no changes in the intercommissural diameter (0.50 mm±0.91 mm vs 40.68 mm±4.7 mm; P=.26). A significant association was seen between anteroposterior diameter reduction and regurgitant orifice area reduction (r=.49; P=.020).
  
  
  CONCLUSIONS
  In patients with functional mitral regurgitation, the MitraClip device produces an immediate reduction in the anteroposterior diameter. This remodeling may be related to the reduction in mitral regurgitation.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. Electronic address: fjhl.87@gmail.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Hidalgo
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Martín
authors.initials: M
authors.lastname: Ruiz
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Delgado
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Rodríguez
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Pardo
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Amador
authors.initials: A
authors.lastname: López
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Romero
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo
mesh_terms: D000368:Aged; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D009929:Organ Size; D012189:Retrospective Studies; D013318:Stroke Volume; D013525:Surgical Instruments
keywords: Anillo mitral; Ecocardiografía tridimensional; Insuficiencia mitral; MitraClip; Mitral annulus; Mitral regurgitation; Three-dimensional echocardiography