Document Detail


Quantitative description of mitral valve geometry using real-time three-dimensional echocardiography.
MedLine Citation:
PMID:  22437133     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: : Leaflet and annular geometry are important determinants of mitral valve (MV) stress. Repair techniques which optimize valvular geometry will reduce stress and potentially increase repair durability. The development of such procedures will require image processing methodologies that provide a quantitative description of three-dimensional valvular geometry. Using three-dimensional echocardiography in conjunction with novel geometric modeling and rendering techniques, we have developed a high-resolution, quantitative, three-dimensional methodology for imaging the human MV.
METHODS: : Five normal adults underwent MV imaging using real-time three-dimensional echocardiography. Using specially designed image analysis software, multiple valvular geometric parameters, including the magnitude and orientation of leaflet curvature, leaflet surface area, annular height, intercommissural width, septolateral annular diameter, and annular area were determined for each subject. Image rendering techniques that allow for the clear and concise presentation of this detailed information are also presented.
RESULTS: : Although three-dimensional annular and leaflet geometry were found to be highly conserved among normal human subjects, substantial regional variation in leaflet geometry was observed. Interestingly, leaflet geometric heterogeneity was most pronounced in the midposterior leaflet, the region most commonly involved in leaflet flail in subjects with myxomatous disease.
CONCLUSIONS: : The image processing and graphical rendering techniques that we have developed can be used to provide a complete description of three-dimensional MV geometry in human subjects. Widespread application of these techniques to normal subjects and patients with MV disease will provide insight into the geometric basis of both valvular pathology and repair durability.
Authors:
Liam P Ryan; Benjamin M Jackson; Thomas J Eperjesi; Theodore J Plappert; Martin St John-Sutton; Robert C Gorman; Joseph H Gorman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Innovations (Philadelphia, Pa.)     Volume:  2     ISSN:  1556-9845     ISO Abbreviation:  Innovations (Phila)     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2012-03-22     Completed Date:  2013-07-04     Revised Date:  2013-09-09    
Medline Journal Info:
Nlm Unique ID:  101257528     Medline TA:  Innovations (Phila)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  -    
Affiliation:
From the *Harrison Department of Surgical Research, and †Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. Supported by National Institutes of Health grants HL63954 (RCG), HL73021, and HL76560 (JHG), and by American Heart Association Postdoctoral Fellowship 0625455U (LPR).
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Grant Support
ID/Acronym/Agency:
R01 HL063954/HL/NHLBI NIH HHS; R01 HL071137/HL/NHLBI NIH HHS; R01 HL073021/HL/NHLBI NIH HHS; R01 HL103723/HL/NHLBI NIH HHS

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