Evaluation of left ventricular reverse remodeling by MitraClip using 3D images / biomarkers

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K08106
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Osaka University
• Principal Investigator: Mizote Isamu 大阪大学, 医学系研究科, 助教 (10584609)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: MitraClip / 4D flow MRI / 機能性僧帽弁逆流症

Outline of Final Research Achievements

The reduction of the regurgitant volume (RVol) by MitraClip can unload the left ventricular volume overload resulting left ventricular reverse remodeling (LVRR). However, the extent of LVRR depends on the remaining RVol after MitraClip. 4D flow MRI is a new technique to quantify the RVol, however, the implanted metal such as MitraClip affect the surrounding MRI flow signals. In this study, we created a cardiac chamber/valve model by resin and implanted MitraClip on this model and evaluated the range of metal artifact affected by the implanted MitraClip. As was previously reported, the flow signal on the annular plane, that was generally 10-20mm far from the tip of mitral valve leaflet in patients with functional mitral regurgitation, was not affected by the implanted MitraClip itself. Therefore, in patients with functional mitral regurgitation, we can quantify the remaining RVol after implantation of MitraClip by applying 4D flow MRI to the mitral valve annular level.

Free Research Field

構造心疾患

Academic Significance and Societal Importance of the Research Achievements

機能性僧帽弁逆流症に対するMitraClipは心不全再入院を回避し、生命予後を改善させることが報告されているが、すべての機能性僧帽弁逆流症を有する症例がいわゆるレスポンダーでないことも明らかにされている。MitraClip後の残存逆流量は左室逆リモデリングに影響すると考えられるが、MitraClip後の逆流量を定量化する方法はこれまでになかった。本研究により、逆流量を経時的に評価することにより左室逆リモデリングへの影響を知ることができるようになる。治療の最適化につながるとともに、本治療の恩恵をうける症例の同定にもつながることになる。