Improvement in echocardiographic mitral regurgitation parameters correlates with left ventricular reverse remodeling after percutaneous mitral annuloplasty.

Abstract

Background: Carillon annuloplasty reduces functional mitral regurgitation (FMR) and induces left ventricular (LV) reverse remodeling.

Aims: This analysis determined whether the change in MR parameters correlated with the extent of LV reverse remodeling after Carillon annuloplasty.

Material and methods: This retrospective pooled analysis included prospectively collected data of 113 consecutive patients undergoing successful Carillon annuloplasty with complete 1-year echocardiographic follow-up. Patients had grade 2+ to 4+ FMR, LV end-diastolic diameter >5.5 cm, and LV ejection fraction <50%.

Results: At 1 year, significant improvements occurred in all MR severity and LV reverse remodeling parameters. Reductions in LV end-diastolic volume and LV end-systolic volume correlated with improvements in regurgitant volume (RV) (r = 0.27 and r = 0.34) and effective regurgitant orifice area (EROA) (r = 0.27 and r = 0.34), but not vena contracta (VC) width. Change in LVEF was associated with change in RV (r = -0.30), EROA (r = -0.32), and VC width (r = -0.40). Decreased mitral annular area correlated significantly with reductions in RV (r = 0.28), EROA (r = 0.28), and VC width (r = 0.34). The change in LVEF also significantly correlated with the reduction in LV end-systolic volume (r = -0.69), LV end-diastolic volume (r = -0.24), LV end-systolic diameter (r = -0.31), and LV end-diastolic diameter (r = -0.31). Significant correlation was observed between the change in mitral annulus area and change in RV (r = 0.28), EROA (r = 0.28), and VC (r = 0.34).

Conclusions: Carillon annuloplasty induces LV reverse remodeling in patients with FMR, with reduced LV diameters and improved LVEF. The degree of improvement in echocardiographic MR parameters after the Carillon procedure significantly correlated with the extent of LV reverse remodeling.