TY - JOUR
T1 - Acute and chronic reduction of functional mitral regurgitation in experimental heart failure by percutaneous mitral annuloplasty
AU - Maniu, Calin V.
AU - Patel, Jeetendra B.
AU - Reuter, David G.
AU - Meyer, Donna M.
AU - Edwards, William D.
AU - Rihal, Charanjit S.
AU - Redfield, Margaret M.
N1 - Funding Information:
This study was funded in part by Cardiac Dimensions, Inc., the Marriott Foundation, the Miami Heart Research Institute, and the Mayo-Dubai Healthcare City Research Program. Dr. Patel is supported by a Mayo Cardiovascular Training Grant (T32-HL07111-27). Dr. Maniu is currently affiliated with the Medical University of South Carolina, Charleston, South Carolina. Drs. Maniu and Patel contributed equally to this study.
PY - 2004/10/19
Y1 - 2004/10/19
N2 - We sought to determine acute and chronic efficacy of a percutaneous mitral annuloplasty (PMA) device in experimental heart failure (HF). Further, we evaluated the potential for adverse effects on left ventricular (LV) function and coronary perfusion. Reduction of mitral annular dimension with a PMA device in the coronary sinus may reduce functional mitral regurgitation (MR) in advanced HF. Study 1: a PMA device was placed acutely in anesthetized open-chest dogs with rapid pacing-induced HF (n = 6) instrumented for pressure volume analysis. Study 2: in 12 anesthetized dogs with HF, fluoroscopic-guided PMA was performed, and dogs were followed for four weeks with continuing rapid pacing. Study 1: percutaneous mitral annuloplasty reduced annular dimension and severity of MR at baseline and with phenylephrine infusion to increase afterload (MR jet/left atrial [LA] area 26 ± 1% to 7 ± 2%, p < 0.05). Pressure volume analysis demonstrated no acute impairment of LV function. Study 2: no device was placed in two dogs because of prototype size limitations. Attempted PMA impaired coronary flow in three dogs. Percutaneous mitral annuloplasty (n = 7) acutely reduced MR (MR jet/LA area 43 ± 4% to 8 ± 5%, p < 0.0001), regurgitant volume (14.7 ± 2.1 ml to 3.1 ± 0.5 ml, p < 0.05), effective regurgitant orifice area (0.130 ± 0.010 cm 2 to 0.040 ± 0.003 cm 2, p < 0.05), and angiographic MR grade (2.8 ± 0.3 device to 1.0 ± 0.3 device, p < 0.001). In the conscious state, MR was reduced at four weeks after PMA (MR jet/LA area 33 ± 3% HF baseline vs. 11 ± 4% four weeks after device, p < 0.05) Percutaneous mitral annuloplasty results in acute and chronic reduction of functional MR in experimental HF.
AB - We sought to determine acute and chronic efficacy of a percutaneous mitral annuloplasty (PMA) device in experimental heart failure (HF). Further, we evaluated the potential for adverse effects on left ventricular (LV) function and coronary perfusion. Reduction of mitral annular dimension with a PMA device in the coronary sinus may reduce functional mitral regurgitation (MR) in advanced HF. Study 1: a PMA device was placed acutely in anesthetized open-chest dogs with rapid pacing-induced HF (n = 6) instrumented for pressure volume analysis. Study 2: in 12 anesthetized dogs with HF, fluoroscopic-guided PMA was performed, and dogs were followed for four weeks with continuing rapid pacing. Study 1: percutaneous mitral annuloplasty reduced annular dimension and severity of MR at baseline and with phenylephrine infusion to increase afterload (MR jet/left atrial [LA] area 26 ± 1% to 7 ± 2%, p < 0.05). Pressure volume analysis demonstrated no acute impairment of LV function. Study 2: no device was placed in two dogs because of prototype size limitations. Attempted PMA impaired coronary flow in three dogs. Percutaneous mitral annuloplasty (n = 7) acutely reduced MR (MR jet/LA area 43 ± 4% to 8 ± 5%, p < 0.0001), regurgitant volume (14.7 ± 2.1 ml to 3.1 ± 0.5 ml, p < 0.05), effective regurgitant orifice area (0.130 ± 0.010 cm 2 to 0.040 ± 0.003 cm 2, p < 0.05), and angiographic MR grade (2.8 ± 0.3 device to 1.0 ± 0.3 device, p < 0.001). In the conscious state, MR was reduced at four weeks after PMA (MR jet/LA area 33 ± 3% HF baseline vs. 11 ± 4% four weeks after device, p < 0.05) Percutaneous mitral annuloplasty results in acute and chronic reduction of functional MR in experimental HF.
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U2 - 10.1016/j.jacc.2004.03.085
DO - 10.1016/j.jacc.2004.03.085
M3 - Article
C2 - 15489099
AN - SCOPUS:5644271572
SN - 0735-1097
VL - 44
SP - 1652
EP - 1661
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 8
ER -