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New Insights on Carpentier I Mitral Regurgitation from Multidetector Row Computed Tomography.
MedLine Citation:
PMID:  25037679     Owner:  NLM     Status:  Publisher    
The underlying mechanism of mitral regurgitation (MR) because of isolated annulus dilation (Carpentier type I) remains controversial in patients with atrial fibrillation (AF). The present study evaluated changes in mitral valve geometry of patients with AF and structurally and functionally normal left ventricles and mitral leaflets. Grade of MR and left ventricular (LV) function was evaluated with echocardiography. Changes in mitral valve geometry were evaluated with multidetector row computed tomography (MDCT) performed before radiofrequency catheter ablation for AF. From a cohort of 480 patients with drug-refractory AF referred for catheter ablation, 170 patients (mean age 58 ± 10 years, 67% men) with structural and functional normal left ventricles and mitral leaflets were included. The intercommissural and anteroposterior diameter, perimeter, and area of the mitral annulus and left atrial volume were assessed with MDCT and correlated with the grade of MR as assessed with echocardiography. A total of 49 patients (29%) had MR ≥2+. These patients had larger mitral annulus area compared with patients with MR <2+ (665.0 ± 100.6 mm(2)/m(2) vs 530.5 ± 66.6 mm(2)/m(2), p <0.001), whereas LV size and function (ejection fraction 64.9 ± 6.3% vs 63.1 ± 5.7%, p = 0.08) were similar. After adjusting for age, type of AF, hypertension, left atrial volume, and LV end-systolic volume and ejection fraction, the mitral annulus dimensions remained independently correlated with MR ≥2+. In conclusion, in AF patients with structural and functional normal left ventricles and mitral leaflets, MDCT demonstrated that mitral annulus dilation is independently associated with type I MR.
Philippe J van Rosendael; Spyridon Katsanos; Vasileios Kamperidis; Cornelis J Roos; Arthur J H A Scholte; Martin J Schalij; Nina Ajmone Marsan; Jeroen J Bax; Victoria Delgado
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-19
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-7-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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