Mitral regurgitation (MR) in dilated cardiomyopathy (DCM-MR) and MR in ischemic cardiomyopathy (ISC-MR) usually occurs as a result of mitral annulus (MA) dilatation and papillary muscle displacement secondary to global left ventricle remodelling. We propose a method to determine MA area and motion throughout the cardiac cycle and to define papillary muscle position in 3-dimensional space using real-time 3-dimensional echocardiography. Real-time 3-dimensional echocardiography was performed in 24 healthy individuals, and in 30 patients with DCM-MR (n 15) or ISC-MR (n 15). Significant intergroup differences were noted in MA surface area (control: 6.4 1.7 cm2; DCM-MR: 11.1 2.6 cm2; ISC-MR: 9.0 2.0 cm2) and in peak MA motion (control: 8.7 3.0 mm; DCM-MR: 3.4 1.7 mm; ISC-MR: 4.9 1.5 mm). In patients with DCM-MR, papillary muscle symmetry was preserved, whereas in patients with ISC-MR, papillary tethering lengths were unequal as a result of wall-motion abnormalities. Our methodology for dynamic volumetric measurements of the mitral apparatus allows better understanding of MR mechanisms.

Quantification of mitral apparatus dynamics in functional and ischemic mitral regurgitation using real-time 3-dimensional echocardiography

CAIANI, ENRICO GIANLUCA;CERUTTI, SERGIO;
2008-01-01

Abstract

Mitral regurgitation (MR) in dilated cardiomyopathy (DCM-MR) and MR in ischemic cardiomyopathy (ISC-MR) usually occurs as a result of mitral annulus (MA) dilatation and papillary muscle displacement secondary to global left ventricle remodelling. We propose a method to determine MA area and motion throughout the cardiac cycle and to define papillary muscle position in 3-dimensional space using real-time 3-dimensional echocardiography. Real-time 3-dimensional echocardiography was performed in 24 healthy individuals, and in 30 patients with DCM-MR (n 15) or ISC-MR (n 15). Significant intergroup differences were noted in MA surface area (control: 6.4 1.7 cm2; DCM-MR: 11.1 2.6 cm2; ISC-MR: 9.0 2.0 cm2) and in peak MA motion (control: 8.7 3.0 mm; DCM-MR: 3.4 1.7 mm; ISC-MR: 4.9 1.5 mm). In patients with DCM-MR, papillary muscle symmetry was preserved, whereas in patients with ISC-MR, papillary tethering lengths were unequal as a result of wall-motion abnormalities. Our methodology for dynamic volumetric measurements of the mitral apparatus allows better understanding of MR mechanisms.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11311/544716
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