The Journal of Thoracic and Cardiovascular Surgery
Volume 137, Issue 5 , Pages 1063-1070.e2 , May 2009

Regional wall motion abnormalities and scarring in severe functional ischemic mitral regurgitation: A pilot cardiovascular magnetic resonance imaging study

  • Michael Flynn, MB, FRCSI (C/Th)

      Affiliations

    • Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
  • ,
  • Ronan Curtin, MD

      Affiliations

    • Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
    • Department of Radiology, Cleveland Clinic, Cleveland, Ohio
  • ,
  • Edward R. Nowicki, MD, MS

      Affiliations

    • Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
  • ,
  • Jeevanantham Rajeswaran, MSc

      Affiliations

    • Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
  • ,
  • Scott D. Flamm, MD

      Affiliations

    • Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
    • Department of Radiology, Cleveland Clinic, Cleveland, Ohio
  • ,
  • Eugene H. Blackstone, MD

      Affiliations

    • Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
    • Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
  • ,
  • Tomislav Mihaljevic, MD

      Affiliations

    • Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
    • Corresponding Author InformationAddress for reprints: Tomislav Mihaljevic, MD, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Avenue/Desk F24, Cleveland, OH 44195.

Received 8 May 2008 ,Revised 17 November 2008 ,Accepted 25 December 2008.

References 

  1. Tibayan FA, Rodriguez F, Langer F, Zasio MK, Bailey L, Liang D, et al. Annular or subvalvular approach to chronic ischemic mitral regurgitation?. J Thorac Cardiovasc Surg. 2005;129:1266–1275
  2. Levine RA, Hung J, Otsuji Y, Messas E, Liel-Cohen N, Nathan N, et al. Mechanistic insights into functional mitral regurgitation. Curr Cardiol Rep. 2002;4:125–129
  3. Yiu SF, Enriquez-Sarano M, Tribouilloy C, Seward JB, Tajik AJ. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction: a quantitative clinical study. Circulation. 2000;102:1400–1406
  4. Trichon BH, Felker GM, Shaw LK, Cabell CH, O'Connor CM. Relation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure. Am J Cardiol. 2003;91:538–543
  5. Westenberg JJ, van der Geest RJ, Lamb HJ, Versteegh MI, Braun J, Doornbos J, et al. MRI to evaluate left atrial and ventricular reverse remodeling after restrictive mitral annuloplasty in dilated cardiomyopathy. Circulation. 2005;112:I437–I442
  6. Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002;105:539–542
  7. Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343:1445–1453
  8. Diggle PJ, Heagerty PJ, Liang KY, Zeger SL. Analysis of longitudinal data. 2nd ed.. New York: Oxford University Press; 2002;
  9. Kumanohoso T, Otsuji Y, Yoshifuku S, Matsukida K, Koriyama C, Kisanuki A, et al. Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction: quantitative analysis of left ventricular and mitral valve geometry in 103 patients with prior myocardial infarction. J Thorac Cardiovasc Surg. 2003;125:135–143
  10. Tibayan FA, Rodriguez F, Zasio MK, Bailey L, Liang D, Daughters GT, et al. Geometric distortions of the mitral valvular-ventricular complex in chronic ischemic mitral regurgitation. Circulation. 2003;108:II116–II121
  11. Gillinov AM, Wierup PN, Blackstone EH, Bishay ES, Cosgrove DM, White J, et al. Is repair preferable to replacement for ischemic mitral regurgitation?. J Thorac Cardiovasc Surg. 2001;122:1125–1141
  12. Bax JJ, Braun J, Somer ST, Klautz R, Holman ER, Versteegh MI, et al. Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling. Circulation. 2004;110:II103–II108
  13. McGee EC, Gillinov AM, Blackstone EH, Rajeswaran J, Cohen G, Najam F, et al. Recurrent mitral regurgitation after annuloplasty for functional ischemic mitral regurgitation. J Thorac Cardiovasc Surg. 2004;128:916–924
  14. Mihaljevic T, Lam BK, Rajeswaran J, Takagaki M, Lauer MS, Gillinov AM, et al. Impact of mitral valve annuloplasty combined with revascularization in patients with functional ischemic mitral regurgitation. J Am Coll Cardiol. 2007;49:2191–2201
  15. Hundley WG, Morgan TM, Neagle CM, Hamilton CA, Rerkpattanapipat P, Link KM. Magnetic resonance imaging determination of cardiac prognosis. Circulation. 2002;106:2328–2333
  16. Pohl T, Seiler C, Billinger M, Herren E, Wustmann K, Mehta H, et al. Frequency distribution of collateral flow and factors influencing collateral channel development. Functional collateral channel measurement in 450 patients with coronary artery disease. J Am Coll Cardiol. 2001;38:1872–1878
  17. Bolling SF, Pagani FD, Deeb GM, Bach DS. Intermediate-term outcome of mitral reconstruction in cardiomyopathy. J Thorac Cardiovasc Surg. 1998;115:381–386discussion 7-8
  18. Kron IL, Green GR, Cope JT. Surgical relocation of the posterior papillary muscle in chronic ischemic mitral regurgitation. Ann Thorac Surg. 2002;74:600–601
  19. Fukamachi K, Popovic ZB, Inoue M, Doi K, Schenk S, Ootaki Y, et al. Changes in mitral annular and left ventricular dimensions and left ventricular pressure-volume relations after off-pump treatment of mitral regurgitation with the Coapsys device. Eur J Cardiothorac Surg. 2004;25:352–357
  20. Yoon DY, Smedira NG, Nowicki ER, Hoercher K Rajeswaran J, Blackstone EH, et al. Decision-making in surgical management of ischemic cardiomyopathy J Thorac Cardiovasc Surg. (in press)
  21. Rajeswaran J, Blackstone EH. Interval estimation for individual categories in cumulative logit models. Stat Med. 2007;26:4150–4162

 Eugene H. Blackstone was supported in part by the Kenneth Gee and Paula Shaw, PhD, Chair in Heart Research.

 This paper was presented at the 88th Annual Meeting of the American Association for Thoracic Surgery, San Diego, California, May 10–14, 2008.

PII: S0022-5223(09)00011-7

doi: 10.1016/j.jtcvs.2008.12.023

The Journal of Thoracic and Cardiovascular Surgery
Volume 137, Issue 5 , Pages 1063-1070.e2 , May 2009