{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:31:52Z","timestamp":1768782712965,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,21]],"date-time":"2019-02-21T00:00:00Z","timestamp":1550707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["1K23 HL140092\u201001"],"award-info":[{"award-number":["1K23 HL140092\u201001"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["1R01HL128278\u201001"],"award-info":[{"award-number":["1R01HL128278\u201001"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess impact of left ventricular (LV) chamber remodeling on MitraClip (MClp) response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>MitraClip is the sole percutaneous therapy approved for mitral regurgitation (MR) but response varies. LV dilation affects mitral coaptation; determinants of MClp response are uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>LV and mitral geometry were quantified on pre\u2010 and post\u2010procedure two\u2010dimensional (2D) transthoracic echocardiography (TTE) and intra\u2010procedural three\u2010dimensional (3D) transesophageal echocardiography (TEE). Optimal MClp response was defined as \u2264mild MR at early (1\u20136 month) follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010seven degenerative MR patients underwent MClp: Whereas MR decreased \u22651 grade in 94%, 39% of patients had optimal response (\u2264mild MR). Responders had smaller pre\u2010procedural LV end\u2010diastolic volume (94\u2009\u00b1\u200924 vs. 109\u2009\u00b1\u200925\u2009mL\/m<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u20090.02), paralleling smaller annular diameter (3.1\u2009\u00b1\u20090.4 vs. 3.5\u2009\u00b1\u20090.5 cm, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), and inter\u2010papillary distance (2.2\u2009\u00b1\u20090.7 vs. 2.5\u2009\u00b1\u20090.6 cm, <jats:italic>p<\/jats:italic>\u2009=\u20090.04). 3D TEE\u2010derived annular area correlated with 2D TTE (r\u2009=\u20090.59, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and was smaller among optimal responders (12.8\u2009\u00b1\u20092.1 cm<jats:sup>2<\/jats:sup> vs. 16.8\u2009\u00b1\u20094.4 cm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Both 2D and 3D mitral annular size yielded good diagnostic performance for optimal MClp response (AUC 0.73\u20130.84, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). In multivariate analysis, sub\u2010optimal MClp response was associated with LV end\u2010diastolic diameter (OR 3.10 per\u2010cm [1.26\u20137.62], <jats:italic>p<\/jats:italic>\u2009=\u20090.01) independent of LA size (1.10 per\u2010cm<jats:sup>2<\/jats:sup> [1.02\u20131.19], <jats:italic>p<\/jats:italic>\u2009=\u20090.01); substitution of mitral annular diameter for LV size yielded an independent association with MClp response (4.06 per\u2010cm<jats:sup>2<\/jats:sup> [1.03\u201315.96], <jats:italic>p<\/jats:italic>\u2009=\u20090.045).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among degenerative MR patients undergoing MClp, LV and mitral annular dilation augment risk for residual or recurrent MR, supporting the concept that MClp therapeutic response is linked to sub\u2010valvular remodeling.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28147","type":"journal-article","created":{"date-parts":[[2019,2,21]],"date-time":"2019-02-21T11:46:39Z","timestamp":1550749599000},"page":"1152-1160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Left ventricular geometry predicts optimal response to percutaneous mitral repair via MitraClip: Integrated assessment by two\u2010 and three\u2010dimensional echocardiography"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8420-8604","authenticated-orcid":false,"given":"Jiwon","family":"Kim","sequence":"first","affiliation":[{"name":"Greenberg Cardiology Division Weill Cornell Medicine  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javid","family":"Alakbarli","sequence":"additional","affiliation":[{"name":"Greenberg Cardiology Division Weill Cornell Medicine  New York New 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