Mitral regurgitation, edge‐to‐edge valve repair and the left atrium: one step beyond the left ventricle?

Abstract

This article refers to 'Impact of left atrial diameter on outcome in patients undergoing edge-to-edge mitral valve repair: results from the German TRAnscatheter Mitral valve Interventions (TRAMI) registry' by C. Iliadis et al., published in this issue on pages 1202-1210.

Reply to the letter regarding the article ‘Clinical implications of left atrial changes after optimization of medical therapy in patients with heart failure’

“…5 As correctly pointed out by Yu et al, along with medical therapy, also the use of device such as cardiac resynchronization therapy (CRT) and Mitra-Clip system have been shown to favour LA reverse remodelling with a beneficial impact on prognosis. 6,7 As reported by the authors, also previous analysis from the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT) 6 study showed that reductions in LA volume with CRT-defibrillator (CRT-D) at 1 year were highly associated with reduction in LV volume, suggesting a cause-effect relationship. In this trial, most CRT-D patients experienced ≥20% reduction in LA volume, while the implantable cardioverter-defibrillator (ICD)-only group had a significantly lower LA response.…”