Trial reportCirculation2016
Impact of Left Ventricular to Mitral Valve Ring Mismatch on Recurrent Ischemic Mitral Regurgitation After Ring Annuloplasty.
2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in Circulation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 26 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 2 pooled it
6.7field-weighted citation impact, top 3% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Surgical Interventions for Moderate Ischemic Mitral Regurgitation
Evaluation of Outcomes Following Mitral Valve Repair/Replacement in Severe Chronic Ischemic Mitral Regurgitation
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Ischemic functional mitral regurgitation: from pathophysiological concepts to current treatment options. A systemic review for optimal strategy.General thoracic and cardiovascular surgery · 2021Pooled it
- Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review.BioMed research international · 2021Pooled it
- Cost-Effectiveness of Mitral Valve Repair Versus Replacement for Severe Ischemic Mitral Regurgitation: A Randomized Clinical Trial From the Cardiothoracic Surgical Trials NetworkCirculation. Cardiovascular quality and outcomes · 2018Trial
- Emerging evidence on transcatheter edge-to-edge repair for secondary mitral regurgitation.The Journal of international medical research · 2025Review
- Comparing surgical techniques and results of secondary ischemic mitral regurgitation: a state-of-the-art literature review.Annals of translational medicine · 2024Review
- Long-term follow-up of posterior mitral leaflet extension for Type IIIb ischemic mitral regurgitation.JTCVS open · 2024Article
- Effect of papillary muscle approximation on acute ovine functional tricuspid regurgitation.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Impact of reductive tricuspid ring annuloplasty on right ventricular size, geometry and strain in an ovine model of functional tricuspid regurgitation.Interactive cardiovascular and thoracic surgery · 2022Article
- Surgical mitral valve repair technique considerations based on the available evidence.Turk gogus kalp damar cerrahisi dergisi · 2022Review
- Commentary: London Bridge is falling down-how will we build it up?JTCVS techniques · 2021Article
- Long-term outcomes of etiology specific annuloplasty ring repair of ischemic mitral regurgitation.Annals of cardiothoracic surgery · 2021Article
- Secondary valve regurgitation in patients with heart failure with preserved ejection fraction, heart failure with mid-range ejection fraction, and heart failure with reduced ejection fraction.European heart journal · 2020Review
- Intraoperative post-annuloplasty three-dimensional valve analysis does not predict recurrent ischemic mitral regurgitation.Journal of cardiothoracic surgery · 2020Article
- Surgical intervention for ischemic mitral regurgitation: how can we achieve better outcomes?Surgery today · 2020Review
- Wisdom of experience or faculty of reason: Ischemic mitral regurgitation trials-Cardiothoracic Surgical Trials Network and beyond.JTCVS open · 2020Article
- Subannular repair for moderate to severe ischemic mitral regurgitation: Still a long way to go. Authors' reply.Cardiology journal · 2020Article
- The Choice of Treatment in Ischemic Mitral Regurgitation With Reduced Left Ventricular Function.The Annals of thoracic surgery · 2019Review
- Left ventricular geometry predicts optimal response to percutaneous mitral repair via MitraClip: Integrated assessment by two- and three-dimensional echocardiography.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2019Article
- Direct Percutaneous Mitral Annuloplasty in Patients With Functional Mitral Regurgitation: When and How.Frontiers in cardiovascular medicine · 2019Review
- Mitral valve interventions in heart failure.ESC heart failure · 2018Review
Corrections and comments
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Authors and funding
21 authors at 1 institution in 1 country.
Romain CapouladeFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Xin ZengFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Jessica R OverbeyFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Gorav AilawadiFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
John H AlexanderFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Deborah AscheimFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Michael BowdishFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Annetine C GelijnsFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Paul GrayburnFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Irving L KronFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Robert A LevineFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Michael J MackFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Serguei MelnitchoukFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Robert E MichlerFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
John C MullenFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Patrick O'GaraFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Michael K ParidesFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Peter SmithFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Pierre VoisineFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.).
Judy HungFrom Division of Cardiology (R.C., X.Z., R.A.L., J.H.) and Department of Surgery (S.M.), Massachusetts General Hospital, Boston, MA; Department of Population Health Science and Policy/Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.R.O., D.A., A.C.G., M.K.P.); Department of Surgery Heart and Vascular Center, University of Virginia Health System, Charlottesville, VA (G.A., I.L.K.); Division of Cardiology, Duke Clinical Research Institute (J.H.A.) and Department of Surgery (P.S.), Duke Medicine, Durham, NC; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA (M.B.); Department of Cardiology, Baylor Heart and Vascular Institute, Dallas, TX (P.G.); Department of Cardiovascular Medicine, Baylor Scott & White Health, Plano, TX (M.J.M.); Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Bronx, NY (R.E.M.); Department of Surgery, Mackenzie Health Sciences Center, Edmonton, AB, Canada (J.C.M.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.O.); and Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, QC, Canada (P.V.). jhung@mgh.harvard.edu.
Cardiothoracic Surgical Trials Network (CTSN) Investigators
Massachusetts General Hospital · US
Funding
REVISED CAROL ACT IIU01HL088942 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GELIJNS, ANNE CHRISTINE, MOSKOWITZ, ALAN J · 2007 to 2025
$122.6MNetwork for Cardiothoracic Surgical Investigations in Cardiovascular MedicineUM1HL088925 · NHLBI · UNIVERSITY OF VIRGINIA · PI BADHWAR, VINAY, KRON, IRVING L. · 2013 to 2025
$6.8MImproving Mitral Compensation in Ischemic RegurgitationR01HL109506 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI AIKAWA, ELENA, BISCHOFF, JOYCE E. · 2012 to 2015
$3.3MTreating Ventricle and Valve: New Synergies for Ischemic LV Remodeling with MRR01HL128099 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI AKAR, FADI GABRIEL, LEVINE, ROBERT A · 2016 to 2019
$2.8MCardiothoracic Surgical Network Clinical CenterU01HL088953 · NHLBI · DUKE UNIVERSITY · PI SMITH, PETER K · 2007 to 2013
$2.6MCore Clinical Centers for the CTSNUM1HL088953 · NHLBI · DUKE UNIVERSITY · PI SMITH, PETER K · 2013 to 2017
$2.5MPolymer Therapy for Ischemic Mitral RegurgitationR01HL092101 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI HUNG, JUDY W · 2009 to 2013
$2.1MMitral Regurgitation, Heart Failure and Coronary Disease: Benefits to MV RepairUM1HL088939 · NHLBI · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI MICHLER, ROBERT E. · 2013 to 2016
$1.5MNHLBI NIH HHS R01 HL092101NHLBI NIH HHS R01 HL109506NHLBI NIH HHS R01 HL128099NHLBI NIH HHS U01 HL088942NHLBI NIH HHS U01 HL088953NHLBI NIH HHS UM1 HL088925NHLBI NIH HHS UM1 HL088939NHLBI NIH HHS UM1 HL088953
Abstract
backgroundIn ischemic mitral regurgitation (IMR), ring annuloplasty is associated with a significant rate of recurrent MR. Ring size is based on intertrigonal distance without consideration of left ventricular (LV) size. However, LV size is an important determinant of mitral valve (MV) leaflet tethering before and after repair. We aimed to determine whether LV-MV ring mismatch (mismatch of LV size relative to ring size) is associated with recurrent MR in patients with IMR after restrictive ring annuloplasty.
methodsPatients with moderate or severe IMR from the 2 Cardiothoracic Surgical Trials Network IMR trials who received MV repair were examined at 1 year after surgery. Baseline LV size was assessed by LV end-diastolic dimension and LV end-systolic dimension (LVESd). LV-MV ring mismatch was calculated as the ratio of LV to ring size (LV end-diastolic dimension/ring size and LVESd/ring size).
resultsAt 1 year after ring annuloplasty, 45 of 214 patients with MV repair (21%) had moderate or greater MR. In univariable logistic regression analysis, larger LVESd (P=0.02) and LVESd/ring size (P=0.007) were associated with recurrent MR. In multivariable models adjusted for age, sex, baseline LV ejection fraction, and severe IMR, only LVESd/ring size (odd ratio per 0.5 increase, 2.20; 95% confidence interval, 1.05-4.62; P=0.038) remained significantly associated with 1-year MR recurrence.
conclusionsLV-MV ring size mismatch is associated with increased risk of MR recurrence. This finding may be helpful in guiding choice of ring size to prevent recurrent MR in patients undergoing MV repair and in identifying patients who may benefit from MV repair with additional subvalvular intervention or MV replacement rather than repair alone. CLINICAL
trial registrationURL:http://clinicaltrials.gov. Unique identifiers: NCT00806988 and NCT00807040.
Indexed as
Cardiac Valve AnnuloplastyHeart VentriclesMitral Valve InsufficiencyMyocardial IschemiaAgedFemaleFollow-Up StudiesHumansMaleMiddle Agedischemic heart diseasemitral regurgitationmitral valvemitral valve annuloplasty
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Read underepoch 390
Registered trials
NCT00806988ClinicalTrials.gov
NCT00807040ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.