Restrictive mitral annuloplasty with or without surgical ventricular reconstruction in ischaemic cardiomyopathy: impacts on neurohormonal activation, reverse left ventricular remodelling and survival

Aims In the STICH trial, adding surgical ventricular reconstruction (SVR) to coronary artery bypass grafting (CABG) reduced LV end‐systolic volume index (LVESVI) by 19%, as compared with 6% with CABG alone, providing no survival or functional benefits. Herein, we compared the efficacy of restrictive mitral annuloplasty (RMA) alone with that of RMA combined with SVR in patients with functional mitral regurgitation (MR). Methods and results One hundred and six patients with ischaemic cardiomyopathy underwent RMA with (n = 52) or without SVR (n = 54) for functional MR. Pre‐ and post‐operative (1 month) left ventriculography and longitudinal measurements of plasma BNP were performed. Pre‐operatively, patients who underwent RMA plus SVR had a larger LVESVI (126 ± 26 vs. 100 ± 24 mL/m2, P