Bloqueio do ramo esquerdo é ruim para a Mitral : O Mitralclip do BRE.

Conclusions

Cardiac resynchronization therapy in patients with LBBB and secondary MR results in LV and MV geometric reverse remodeling and decreases MR severity. Extent of baseline MV tethering is independently associated with persistent MR at follow‐up.

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The modified biplane Simpson’s method was used to calculate the LV end‐systolic volume, end‐diastolic volume, and ejection fraction, while the area‐length method was used to obtain the left atrial volume

Left ventricular ejection fraction (%)25 ± 8 Pré32 ± 11 Pós<.001
Mitral regurgitation vena contracta width
(cm)
0.34 ± 0.16
pré
0.28 ± 0.21
pós
.01

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Com os estudos de Strain, descobrimos que o BRE é um desastre para a eficiência efetiva . Em seguida :

Finalmente um uso racional e verdadeiro da ressincronização

Ao demonstrar redução na VC, o método busca um uso realmente interessante para o paciente .

Seria o MitralClip do BRE????

Clinical outcomes

The mean time to last clinical follow‐up was 4.0 ± 1.9 years and was 100% complete. There was a significant reduction in the mean New York Heart Association functional class (2.9 ± 0.6 vs 2.2 ± 1.1) and prevalence of class III or IV symptoms (81% vs 37%), when compared with baseline values (P < .001 for both). During this time period, there were 8 (20%) deaths, with 3 (7%) additional patients undergoing LV assist device implantation, or cardiac transplantation.

https://doi.org/10.1111/echo.14444

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