Document Detail

Local dysfunction and asymmetrical deformation of mitral annular geometry in ischemic mitral regurgitation: a novel computerized 3D echocardiographic analysis.
MedLine Citation:
PMID:  18177391     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Most studies of the pathogenesis of functional mitral regurgitation (MR) have focused on alterations in ventricular function and geometry. We used a novel 3D echocardiographic method to assess abnormalities in mitral annular (MA) geometry and motion in patients with ischemic MR (IMR) and compared these data to those obtained from normal subjects and from patients with MR caused by dilated cardiomyopathy (DMR). METHODS: Real time 3D echo was performed in 12 normal subjects, 25 with IMR, and 14 with DMR. Eight points along the saddle-shaped MA were identified using our software at systole and diastole. From these eight points, four annular diameters at each cardiac phase were determined. Annular motion was assessed by measuring local displacement (LD) of a given point between systole and diastole. RESULTS: Annular motion was different between groups: IMR had smaller LD in posterior MA segments than did normals (2.6 +/- 1.1 vs 4.8 +/- 1.9 mm, P < 0.01), while DMR had globally reduced LD. In IMR systolic MA dilatation was striking in the anterior-posterior (diameter; IMR vs controls, 28.3 +/- 3.5 vs 22.5 +/- 2.2 mm, P< 0.05) and anterolateral-posteromedial (31.7 +/- 3.5 vs 25.1 +/- 2.2 mm, P < 0.05) directions; in IMR, systolic MA diameters in these two directions correlated with MR severity(P = 0.02). MA dilatation occurred globally in DMR. CONCLUSION: This novel 3D echo method demonstrated that MA motion and dilatation were asymmetric in IMR and symmetric in DMR. These differences in MA geometry and motion may aid in the development of distinct new therapies for IMR and DMR.
Masao Daimon; Giuseppe Saracino; A Marc Gillinov; Yasushi Koyama; Shota Fukuda; Jun Kwan; Jong-Min Song; Vorachai Kongsaerepong; Deborah A Agler; James D Thomas; Takahiro Shiota
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-01-03
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  25     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-27     Completed Date:  2008-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  414-23     Citation Subset:  IM    
Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Cardiac Volume / physiology
Echocardiography, Three-Dimensional / methods*
Middle Aged
Mitral Valve / physiopathology,  ultrasonography*
Mitral Valve Insufficiency / complications,  physiopathology*,  ultrasonography
Myocardial Ischemia / complications,  physiopathology*,  ultrasonography
Reproducibility of Results
Severity of Illness Index
Ventricular Function, Left / physiology*

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