Local LV Remodeling Linked to Mitral Regurgitation

Cardiac resynchronization therapy reduces MR in patients with idiopathic dilated cardiomyopathy

FRIDAY, Oct. 21 (HealthDay News) -- For patients with idiopathic dilated cardiomyopathy (IDC) and wide QRS durations, local left ventricular (LV) remodeling contributes toward development of mitral regurgitation (MR), which can be reduced by cardiac resynchronization therapy (CRT), according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

Kensuke Matsumoto, M.D., from the Kobe University Graduate School of Medicine in Japan, and colleagues investigated whether local LV remodeling contributed toward the development of MR in patients with IDC and wide QRS durations, and whether it could be reversed with CRT. A total of 44 patients who underwent CRT were compared with 40 age- and gender-matched controls.

The investigators found that, compared to controls, the anterolateral papillary muscle (APM) was displaced more posteriorly in patients with IDC, while the position of the posteromedial papillary muscle was similar in both the groups. On multivariate analysis, reduction in coaptation height and LV dyssynchrony were independent predictors of MR reduction after an average of five days after CRT. An average of six months after CRT, MR reduction was independently predicted by restoration of the position of the posteriorly displaced APM, and by the increase in sphericity index.

"Asymmetric local LV remodeling was observed at baseline, and asymmetric local LV reverse remodeling was observed at long-term follow-up after CRT in patients with IDC. Furthermore, different parameters contribute to the reduction in MR observed at short- and long-term follow-up after CRT," the authors write.

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