Non invasive evaluation of cardiomechanics in patients undergoing MitraClip procedure

Cardiovascular Ultrasound

Research

Anna S Petronio¹  Cristina Giannini¹  Vitantonio Di Bello¹  Francesco Forfori²  Pietro Bertini²  Fabio Guarracino²  Rubia Baldassarri²  Baldassare Ferro³ 

[1] Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy;Department of Cardiothoracic Anesthesia and Intensive Care Medicine, Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56123, Italy;Department of Cardiothoracic Anesthesia and Intensive Care Medicine, Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56123, Italy;Scuola Superiore di Studi Universitari e di Perfezionamento Sant’Anna, Piazza Santa Caterina, Pisa, Italy;

关键词: Mitraclip;    Ventricular arterial coupling;    Cardiomechanic;   

DOI  :  10.1186/1476-7120-11-13

 received in 2013-02-19, accepted in 2013-04-26,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundIn the last recent years a new percutaneous procedure, the MitraClip, has been validated for the treatment of mitral regurgitation. MitraClip procedure is a promising alternative for patients unsuitable for surgery as it reduces the risk of death related to surgery ensuring a similar result. Few data are present in literature about the variation of hemodynamic parameters and ventricular coupling after Mitraclip implantation.MethodsHemodynamic data of 18 patients enrolled for MitraClip procedure were retrospectively reviewed and analyzed. Echocardiographic measurements were obtained the day before the procedure (T0) and 21 ± 3 days after the procedure (T1), including evaluation of Ejection Fraction, mitral valve regurgitation severity and mechanism, forward Stroke Volume, left atrial volume, estimated systolic pulmonary pressure, non invasive echocardiographic estimation of single beat ventricular elastance (Es(sb)), arterial elastance (Ea) measured as systolic pressure • 0.9/ Stroke Volume, ventricular arterial coupling (Ea/Es(sb) ratio). Data were expressed as median and interquartile range. Measures obtained before and after the procedure were compared using Wilcoxon non parametric test for paired samples.ResultsMitraclip procedure was effective in reducing regurgitation. We observed an amelioration of echocardiographic parameters with a reduction of estimated systolic pulmonary pressure (45 to 37,5 p = 0,0002) and left atrial volume (110 to 93 p = 0,0001). Despite a few cases decreasing in ejection fraction (37 to 35 p = 0,035), the maintained ventricular arterial coupling after the procedure (P = 0,67) was associated with an increasing in forward stroke volume (60,3 to 78 p = 0,05).ConclusionMitraClip is effective in reducing mitral valve regurgitation and determines an amelioration of hemodynamic parameters with preservation of ventricular arterial coupling.

【 授权许可】

CC BY   
© Guarracino et al.; licensee BioMed Central Ltd. 2013