September 10, 2013Circulation
Late Repair of Ischemic Mitral Regurgitation Does Not Prevent Left Ventricular Remodeling
Why the study?
Does late repair of ischemic mitral regurgitation improve LV remodeling in a sheep model of myocardial infarction with volume overload?
Population
12 sheep with distal left anterior descending coronary artery ligation to create apical myocardial…
Comparison
Shunt closure at 90 days post-infarction vs Sham (no repair) at 90 days post-infarction
Design
Preclinical, Randomized
Follow-up
135 days (45 days post-randomization)
Authors
Discussion
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Implication
Late ischemic MR repair may not improve LV remodeling despite overload correction; leaves open optimal intervention timing post-MI.
Structured PICO
Does late repair of ischemic mitral regurgitation improve LV remodeling in a sheep model of myocardial infarction with volume overload?
P
Population
12 sheep with distal left anterior descending coronary artery ligation to create apical myocardial infarction and implantation of an LV-to-left atrium shunt to create standardized moderate volume overload
I
Intervention
Shunt closure (late repair) at 90 days post-infarction
C
Comparator
Sham (no repair) at 90 days post-infarction
O
Outcome
Left ventricular remodeling assessed by 3-dimensional echocardiography (LV volumes), dP/dt, preload-recruitable stroke work, and myocardial biopsies at 135 dayssurrogate
Late correction of moderate volume overload after myocardial infarction in a sheep model did not improve LV volume or contractility, suggesting a limited window of opportunity for beneficial ischemic MR repair.
Cite This Study
Beaudoin et al. (2013) studied this question.