Effects of surgery on ischaemic mitral regurgitation: a prospective multicentre registry (SIMRAM registry)
1 Department of Cardiology, University Hospital, CHU Sart Tilman, B-4000 Liège, Belgium
2 CHU de Ponchaillou, Rennes, France
3 CHIREC, Site Braine l'Alleud, Belgium
4 AZ-VUB, Brussels, Belgium
5 Hôpital Henri Mondor, Créteil, France
6 Hôpital Bichat, Claude-Bernard, Paris, France
7 Hôpital Georges Pompidou, Paris, France
8 Hôpital Laval, Québec; Canada
9 Saint Augustin, Bordeaux, France
10 Hjertemedicinsk Klinik, Rigshospitalet, Denmark
11 University of Milan, Milan, Italy
12 CHUR, Amiens, France
13 Haut-Lévêque, Pessac, France
14 Wales College of Medicine, Cardiff, UK
15 Lyon, France
16 Onassis Cardiac, Surgery Center, Athens, Greece
17 Leiden University Medical Center, Leiden, The Netherlands
Received 15 October 2006; accepted after revision 23 December 2006; online publish-ahead-of-print 9 March 2007.
* Corresponding author. Tel: +32 4 366 71 94; fax: +32 4 366 71 95 (P. Lancellotti). E-mail addresses: plancellotti{at}chu.ulg.ac.be, lpierard{at}chu.ulg.ac.be
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Abstract |
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Aims: Functional ischaemic mitral regurgitation (IMR) is common in patients with ischaemic left ventricular dysfunction undergoing coronary artery bypass surgery. Although the presence of IMR negatively affects prognosis, the additional benefit of valve repair is debated, particularly with mild IMR at rest. Exercise echocardiography may help identify a subset of patients at higher risk of cardiovascular events by revealing the dynamic component of IMR.
Methods: A large prospective, multicentre, non-randomized registry is designed to evaluate the effects of surgery on IMR at rest and on its dynamic component at exercise (z). SIMRAM will enrol approximately 550 patients with IMR in up to 17 centres with clinical and exercise follow-up for 1 year. Three sets of outcomes will be prospectively assessed and several hypotheses will be tested including determinants of adverse outcome and progressive left ventricular remodeling, efficacy of treatment and role of ischaemia on the dynamic consequences of IMR. Enrolment began in November 2006 and is expected to end by early 2008.
Keywords: Mitral regurgitation; Surgery; Exercise; Echocardiography
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