CRT for high operative risk functional MR
CRT for high operative risk functional MR: Cardiac resynchronization therapy (CRT) is being explored as an option for high operative risk moderate to severe functional mitral regurgitation. Functional mitral regurgitation is common in heart failure with dilated cardiomyopathy and has implications in the prognosis of the patient. But these patients are seldom offered surgical correction because of the high surgical risk.
van Bommel and colleagues studied the role of cardiac resynchronization therapy in this group of patients . About hundred patients with moderate-severe functional mitral regurgitation and high operative risk as per the current guidelines. About half of them had one or more grades of improvement in mitral regurgitation and were considered as mitral regurgitation improvers. Superior survival was noted in those who had reduction of mitral regurgitation compared to those who did not improve. Improvement in mitral regurgitation was noted to be an independent predictor of survival with a hazard ratio of 0.35. The authors conclude that CRT is a potential option for those in heart failure with moderate-severe functional mitral regurgitation.
- Rutger J van Bommel, Nina Ajmone Marsan, Victoria Delgado, C Jan Willem Borleffs, Eva P M van Rijnsoever, Martin J Schalij, Jeroen J Bax. Cardiac Resynchronization Therapy as a Therapeutic Option in Patients With Moderate-Severe Functional Mitral Regurgitation and High Operative Risk. Circulation. 2011 Aug 23;124(8):912-9.