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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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Left atrium remodelling and BNP levels after Mitraclip therapy
Session:
Posters 3 - Écran 07 - Ecocardiografia
Speaker:
Rita Loreto Ilhão Moreira
Congress:
CPC 2018
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Posters
FP Number:
---
Authors:
Rita Ilhão Moreira; Luís Almeida Morais; Luisa Moura Branco; Filipa Ferreira; Mafalda Selas; Tânia Branco Mano; António Valentim Gonçalves; Tiago Mendonça; Inês Rodrigues; Pedro Modas Daniel; Sílvia Aguiar Rosa; Pedro Rio; Joao Abreu; Ana Galrinho; António Fiarresga; Duarte Cacela; Rui Cruz Ferreira
Abstract
<p><strong>Background: </strong>Mitraclip device has been suggested to effectively improve functional and clinical outcomes in high-risk patients with mitral regurgitation (MR). Plasma levels of brain natriuretic peptide (BNP) have been shown to reduce after Mitraclip therapy. However, the role of this compound as a non-invasive marker of left atrial (LA) dysfunction is yet to be established.</p> <p><strong>Aims: </strong>The study aim was to correlate levels of BNP changes with LA function assessed by two-dimensional speckle tracking echocardiography after percutaneous mitral valve repair with Mitraclip system.</p> <p><strong>Methods: </strong>A total of 27 consecutive patients with moderate-to-severe or severe MR were included. Patients underwent clinical, functional, laboratory and echocardiographic evaluation before and 6 months after the clip implantation. LA reservoir (SR-LAs), conduit (SR-LAe) and booster-pump (SR-LAa) functions were determined as the averaged global LA speckle tracking longitudinal strain rate from apical four-chamber views. Venous blood samples were withdrawn to monitor BNP levels during the same period.</p> <p><strong>Results: </strong>Mean BNP level decreased after Mitraclip implantation (589 pg/mL before and 468 pg/mL six month after) and functional capacity assessed by the 6-minute walk test was improved (318 m to 344 m). At 6 month follow-up, mean left ventricular ejection fraction change was 0.8% and it was not correlated to BNP level changes (p 0.463). Conversely, two-dimensional speckle tracking analysis demonstrated that changes in SR-LAs at 6 month follow-up were significantly correlated with changes in BNP levels (p 0.003).</p> <p><strong>Conclusion: </strong>In the studied population, changes in BNP levels correlated significantly with LA reservoir function improvement. BNP levels may be used as a non-invasive marker of left atrial remodelling after Mitraclip therapy.</p>
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