Document Detail


Contractile mitral annular forces are reduced with ischemic mitral regurgitation.
MedLine Citation:
PMID:  23111017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Forces acting on mitral annular devices in the setting of ischemic mitral regurgitation are currently unknown. The aim of this study was to quantify the cyclic forces that result from mitral annular contraction in a chronic ischemic mitral regurgitation ovine model and compare them with forces measured previously in healthy animals.
METHODS: A novel force transducer was implanted in the mitral annulus of 6 ovine subjects 8 weeks after an inferior left ventricle infarction that produced progressive, severe chronic ischemic mitral regurgitation. Septal-lateral and transverse forces were measured continuously for cardiac cycles reaching a peak left ventricular pressure of 90, 125, 150, 175, and 200 mm Hg. Cyclic forces and their rate of change during isovolumetric contraction were quantified and compared with those measured in healthy animals.
RESULTS: Animals with chronic ischemic mitral regurgitation exhibited a mean mitral regurgitation grade of 2.3 ± 0.5. Ischemic mitral regurgitation was observed to decrease significantly septal-lateral forces at each level of left ventricular pressure (P < .01). Transverse forces were consistently lower in the ischemic mitral regurgitation group despite not reaching statistical significance. The rate of change of these forces during isovolumetric contraction was found to increase significantly with peak left ventricular pressure (P < .005), but did not differ significantly between animal groups.
CONCLUSIONS: Mitral annular forces were measured for the first time in a chronic ischemic mitral regurgitation animal model. Our findings demonstrated an inferior left ventricular infarct to decrease significantly cyclic septal-lateral forces while modestly lowering those in the transverse. The measurement of these forces and their variation with left ventricular pressure contributes significantly to the development of mitral annular ischemic mitral regurgitation devices.
Authors:
Andrew W Siefert; Jorge H Jimenez; Kevin J Koomalsingh; Fernando Aguel; Dustin S West; Takashi Shuto; Teresa K Snow; Robert C Gorman; Joseph H Gorman; Ajit P Yoganathan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2012-10-27
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  146     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-22     Completed Date:  2013-09-27     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 The American Association for Thoracic Surgery. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Animals
Chronic Disease
Disease Models, Animal
Mitral Valve / physiopathology*
Mitral Valve Insufficiency / etiology*,  physiopathology
Myocardial Contraction*
Myocardial Infarction / complications*,  physiopathology
Sheep
Stress, Mechanical
Time Factors
Transducers, Pressure
Ventricular Function, Left*
Ventricular Pressure
Grant Support
ID/Acronym/Agency:
FDA1061718//PHS HHS; HL63954/HL/NHLBI NIH HHS; HL73021/HL/NHLBI NIH HHS; R01 HL063954/HL/NHLBI NIH HHS; R01 HL073021/HL/NHLBI NIH HHS; R01 HL103723/HL/NHLBI NIH HHS
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