Mitral regurgitation recovery and atrial reverse remodeling following pulmonary vein isolation procedure in patients wit
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POSTER PRESENTATION
Open Access
Mitral regurgitation recovery and atrial reverse remodeling following pulmonary vein isolation procedure in patients with atrial fibrillation: a proof of concept cardiac MRI study Sahadev T Reddy*, William Belden, Mark Doyle, Diane A Vido, June Yamrozik, Ronald B Williams, Robert W Biederman From 15th Annual SCMR Scientific Sessions Orlando, FL, USA. 2-5 February 2012 Summary Atrial reverse remodeling triggered by favorable pulmonary vein isolation for atrial fibrillation results in regression of mitral regurgitation. Background Atrial fibrillation (AF) is a chronic and progressive disease, and if uncontrolled results in permanent remodeling of the myocardium. Reverse remodeling of the left atrium (LA) after the successful pulmonary vein isolation (PVI) in recurrent/chronic AF may occur, however, mitral regurgitation (MR) recovery after the successful PVI has not been demonstrated but would be an important factor in PVI durability. Objective Retrospectively analyze the effectiveness of pulmonary vein isolation (PVI) procedure in patients with AF for evidence of atrial reverse remodeling and recovery of MR via CMR. Methods Prior to PVI, patients underwent a clinically indicated CMRI, post-PVI (6±1months) patients underwent a follow up MRI, and were classified into 2 groups: responders (R) to PVI, non responders (NR) to PVI as assessed by cessation of AF at the end of 3 month blanking period. Further, CMR was used to evaluate the severity of MR (0 to 4+) and to relate changes in MR to LA, LAA volumes as well as mitral apparatus (mitral annulus, Allegheny General Hospital, Pittsburgh, USA
tenting area, tenting height and tenting angle). For continuous variables, group differences were assessed by unpaired or paired two-sample t tests or their non-parametric equivalents. We used chi-square tests for evaluating categorical variables.
Results Of the 94 patients with AF who underwent PVI, 76 (81%) were classified as R and 18 (19%) were classified as NR. Mean age, mean BSA and antiarrhythmic therapies were similar between the groups. MR pre vs. post in the R group significantly improved (Mean 0.78, Median 1.0 vs. Mean 0.51, Median 0, P 0.01) and was matched by favorable mitral geometry reverse remodeling [annulus (34.5 ± 3.9 mm vs. 32.6 ± 3.9 mm, p
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