Effect of cardiac resynchronization therapy on mitral valve geometry: A novel aspect as "reversed mitral remodeling"

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dc.authorid0000-0002-4281-0867
dc.authorid0000-0003-0230-6575
dc.authorid0000-0003-2995-8792
dc.authorid0000-0001-5825-8627
dc.authorid0000-0003-1919-3183
dc.authorid0000-0003-2714-4584
dc.authorid0000-0002-0113-9907
dc.authorid0000-0002-4951-6716
dc.contributor.authorKaraca, Oğuz
dc.contributor.authorÇakal, Beytullah
dc.contributor.authorOmaygenç, Mehmet Onur
dc.contributor.authorGüneş, Hacı Murat
dc.contributor.authorKızılırmak, Filiz
dc.contributor.authorÇakal, Sinem Deniz
dc.contributor.authorNaki, Deniz Dilan
dc.contributor.authorBarutçu, İrfan
dc.contributor.authorBoztosun, Bilal
dc.contributor.authorKılıçaslan, Fethi
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:50:28Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T19:50:28Z
dc.date.issued2018
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.descriptionWOS: 000438113200005
dc.descriptionPubMed ID: 29387972
dc.description.abstractAmelioration of the valvular geometry is a possible mechanism for mitral regurgitation (MR) improvement in patients receiving cardiac resynchronization therapy (CRT). We aimed to establish the precise definition, incidence, and predictors of reversed mitral remodeling (RMR), as well as the association with MR improvement and short-term CRT outcome. Ninety-five CRT recipients were retrospectively evaluated for the end-point of "MR response" defined as the absolute reduction in regurgitant volume (RegV) at 6 months. To identify RMR, changes in mitral deformation indices were tested for correlation with MR response and further analyzed for functional and echocardiographic CRT outcomes. Overall, MR response was observed in 50 patients (53%). Among the echocardiographic indices, the change in tenting area (TA) had the highest correlation with the change in RegV (r = 0.653, p < 0.001). The mean TA significantly decreased in MR responders (4.15 +/- 1.05 to 3.67 +/- 1.01 cm(2) at 6 months, p < 0.001) and increased in non-responders (3.68 +/- 1.04 to 3.98 +/- 0.97 cm(2), p = 0.014). The absolute TA reduction was used to identify patients with RMR (47%) which was found to be associated with higher rates of functional improvement (p = 0.03) and volumetric CRT response (p = 0.036) compared to those without RMR. Non-ischemic etiology and the presence of LBBB independently predicted RMR at multivariate analysis. In conclusion, reduction in TA is a reliable index of RMR, which relates to MR response, and functional and echocardiographic improvement with CRT. LBBB and non-ischemic etiology are independent predictors of RMR.
dc.identifier.citationKaraca, O., Çakal, B., Omaygenç, M. O., Güneş, H. M., Kızılırmak, F., Çakal, S. D. ... Kılıçaslan, F. (2018). Effect of cardiac resynchronization therapy on mitral valve geometry: A novel aspect as "reversed mitral remodeling". International Journal of Cardiovascular Imaging, 34(7), 1029-1040. https://dx.doi.org/10.1007/s10554-018-1308-2
dc.identifier.doi10.1007/s10554-018-1308-2
dc.identifier.endpage1040
dc.identifier.issn1569-5794
dc.identifier.issn1573-0743
dc.identifier.issue7
dc.identifier.scopusqualityQ2
dc.identifier.startpage1029
dc.identifier.urihttps://dx.doi.org/10.1007/s10554-018-1308-2
dc.identifier.urihttps://hdl.handle.net/20.500.12511/1994
dc.identifier.volume34
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofInternational Journal of Cardiovascular Imagingen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectCardiac Resynchronization Therapy
dc.subjectMitral Valve
dc.subjectReverse Remodeling
dc.subjectMitral Regurgitation
dc.subjectTenting Area
dc.titleEffect of cardiac resynchronization therapy on mitral valve geometry: A novel aspect as "reversed mitral remodeling"
dc.typeArticle

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