Published Online
on October 25, 2004

A more recent version of this article appeared on November 9, 2004

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Submitted on January 16, 2004
Revised on June 15, 2004
Accepted on June 21, 2004

Percutaneous Mitral Annular Reduction Provides Continued Benefit in an Ovine Model of Dilated Cardiomyopathy

Melissa J. Byrne BSc, BApSc, David M. Kaye MB, BS, PhD, Mark Mathis BSME, David G. Reuter MD, BSME, Clif A. Alferness BEE, and John M. Power BVSc, PhD^*

From the Department of Applied Cardiovascular Research (M.J.B., J.M.P.) and Wynn Department of Metabolic Cardiology (D.M.K.), Baker Heart Research Institute, Melbourne, Victoria, Australia; and Cardiac Dimensions Inc, Kirkland, Wash (M.M., D.G.R., C.A.A.).

^* To whom correspondence should be addressed. E-mail: john.power{at}baker.edu.au.

Background--Functional mitral valve regurgitation plays a key role in the symptomatic severity and progression of heart failure. In an ovine model of dilated cardiomyopathy, we examined the chronic functional consequences of mitral regurgitation reduction using a recently developed novel percutaneous mitral annular reduction (PMAR) device.

Methods and Results--Fourteen adult sheep were paced right ventricularly at 180 to 190 bpm for 5 weeks, leading to the development of moderate mitral valve regurgitation. After echocardiographic, hemodynamic, and neurohormonal analysis, 9 animals underwent PMAR. All animals were subsequently paced for another 28 days, and a final echocardiographic and hemodynamic study was conducted. Animals that had undergone PMAR showed significantly increased negative and positive dP/dt, whereas pulmonary capillary wedge pressure and mitral valve regurgitation were significantly reduced compared with those at device implant despite continued pacing. In conjunction, significant improvements in plasma norepinephrine and brain natriuretic peptide were apparent.

Conclusions--The application of PMAR in animals with pacing-induced dilated cardiomyopathy and functional mitral valve regurgitation resulted in continued improvements in hemodynamic and neurohormonal parameters.

Key words: mitral valve • regurgitation • catheterization • cardiology • cardiomyopathy

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