What is the clinical evidence from this study?

Study design: Observational. Population: Ischemic cardiomyopathy and moderately severe to severe mitral regurgitation (n=38). Intervention: Combined mitral downsizing by restrictive prosthetic ring annuloplasty and coronary artery bypass grafting (CABG). Primary outcome: Left ventricular ejection fraction (LVEF) (p=<0.001).

April 19, 2005European Journal of Cardio-Thoracic Surgery

Downsizing of the mitral valve and coronary revascularization in severe ischemic mitral regurgitation results in reverse left ventricular and left atrial remodeling

Q: What are the key findings of this study?

Combined mitral downsizing and CABG significantly increased LVEF from 31% to 39% (P<0.001) and reduced left ventricular and atrial dimensions in patients with ischemic cardiomyopathy.

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Key result

Combined mitral downsizing and CABG significantly increased LVEF from 31% to 39% (P<0.001) and reduced left ventricular and atrial dimensions in patients with ischemic cardiomyopathy.

Why the study?

Does combined mitral downsizing and CABG improve reverse LV and LA remodeling in patients with ischemic cardiomyopathy and severe MR?

Population

38 patients with coronary artery disease, ischemic cardiomyopathy and moderately severe to severe mitral…

Design

Cohort

Follow-up

13+/-7 months

Authors

SGStephan GeidelAsklepios Klinik St. Georg CSChristian SchneiderHelmholtz Zentrum München GGG. GrothAsklepios Klinik St. Georg

Discussion

Member takes

Overview

Should not yet change practice; leaves open need for RCTs to confirm remodeling benefit in ischemic MR.

Study Design

Type

Observational (n=38)

Structured PICO

Does combined mitral downsizing and CABG improve reverse LV and LA remodeling in patients with ischemic cardiomyopathy and severe MR?

Population

38 patients (mean age 70.6 years) with coronary artery disease, ischemic cardiomyopathy, and moderately severe to severe mitral regurgitation undergoing CABG and mitral downsizing, followed for up to 13 months.

Exposure

Combined mitral downsizing by restrictive prosthetic ring annuloplasty (by 2-4 ring sizes) and coronary artery bypass grafting (CABG).

Outcome

Reverse left ventricular (LV) and left atrial (LA) remodeling (assessed by echocardiographic dimensions and volumes), survival, NYHA class, MR grade, and leaflet coaptation height.surrogate

Main Result

p-value: p=<0.001

Combined mitral downsizing and CABG in patients with ischemic cardiomyopathy and severe MR leads to significant reverse LV and LA remodeling and clinical improvement.

Cite This Study

Geidel et al. (2005) conducted an observational in Ischemic cardiomyopathy and moderately severe to severe mitral regurgitation (n=38). Combined mitral downsizing by restrictive prosthetic ring annuloplasty and coronary artery bypass grafting (CABG) was evaluated on Left ventricular ejection fraction (LVEF) (p=<0.001). Combined mitral downsizing and CABG significantly increased LVEF from 31% to 39% (P<0.001) and reduced left ventricular and atrial dimensions in patients with ischemic cardiomyopathy.

synapsesocial.com/papers/6a95ba0c3ea7ffc69dbaeb2b https://doi.org/10.1016/j.ejcts.2005.02.025

Topics

Mitral valve intervention Women and heart disease

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April 19, 2005European Journal of Cardio-Thoracic Surgery

Downsizing of the mitral valve and coronary revascularization in severe ischemic mitral regurgitation results in reverse left ventricular and left atrial remodeling

View Full Paper

Ask AI

Bookmark

Key result

Combined mitral downsizing and CABG significantly increased LVEF from 31% to 39% (P<0.001) and reduced left ventricular and atrial dimensions in patients with ischemic cardiomyopathy.

Why the study?

Does combined mitral downsizing and CABG improve reverse LV and LA remodeling in patients with ischemic cardiomyopathy and severe MR?

Population

38 patients with coronary artery disease, ischemic cardiomyopathy and moderately severe to severe mitral…

Design

Cohort

Follow-up

13+/-7 months

Authors

SGStephan GeidelAsklepios Klinik St. Georg CSChristian SchneiderHelmholtz Zentrum München GGG. GrothAsklepios Klinik St. Georg

Discussion

Member takes

Overview

Should not yet change practice; leaves open need for RCTs to confirm remodeling benefit in ischemic MR.

Study Design

Type

Observational (n=38)

Structured PICO

Does combined mitral downsizing and CABG improve reverse LV and LA remodeling in patients with ischemic cardiomyopathy and severe MR?

Population

Exposure

Combined mitral downsizing by restrictive prosthetic ring annuloplasty (by 2-4 ring sizes) and coronary artery bypass grafting (CABG).

Outcome

Reverse left ventricular (LV) and left atrial (LA) remodeling (assessed by echocardiographic dimensions and volumes), survival, NYHA class, MR grade, and leaflet coaptation height.surrogate

Main Result

p-value: p=<0.001

Combined mitral downsizing and CABG in patients with ischemic cardiomyopathy and severe MR leads to significant reverse LV and LA remodeling and clinical improvement.

Cite This Study

synapsesocial.com/papers/6a95ba0c3ea7ffc69dbaeb2b https://doi.org/10.1016/j.ejcts.2005.02.025

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Mitral valve intervention Women and heart disease

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