| The importance of papillary muscle dyssynchrony in predicting the severity of functional mitral regurgitation in patients with non-ischaemic dilated cardiomyopathy: a two-dimensional speckle-tracking echocardiography study. | |
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MedLine Citation:
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PMID: 20237053 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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AIMS: In our study, we investigated the impact of papillary muscle systolic dyssynchrony (DYS-PAP) and the configuration of mitral leaflets in the prediction of significant functional mitral regurgitation (MR) with two-dimensional (2D) speckle-tracking strain analysis in non-ischaemic dilated cardiomyopathy (DCM) patients with sinus rhythm. METHODS: Thirty-six non-ischaemic DCM patients (left ventricular ejection fraction <40%) with sinus rhythm were recruited. The quantification of functional MR was performed using the proximal isovelocity surface area method. The configuration of mitral leaflets [mitral annulus, coaptation height (CH), and tethering distances for papillary muscles] was evaluated in the parasternal long-axis and apical four-chamber views. The assessment of DYS-PAP was performed by applying 2D speckle-tracking imaging to the apical four-chamber view for anterolateral papillary muscle and to the apical long-axis view for posteromedial papillary muscle. RESULTS: Fifteen (41.6%) patients had mild MR and 21 (58.3%) patients had moderate or moderate-to-severe MR. Patients with higher levels of MR had larger mitral annulus size (P = 0.02), tethering-AL (P = 0.04), higher MR volume (P < 0.0001), effective regurgitant orifice area (P < 0.0001), and DYS-PAP (P < 0.0001) values, but lower CH (P = 0.001), global longitudinal (P = 0.005), radial (P = 0.03), and circumferential strain (P = 0.01) than those with mild MR. Receiver operating characteristic analysis was performed to assess the utility of DYS-PAP to predict moderate or moderate-to-severe functional MR. A DYS-PAP value >30 ms predicted moderate-to-severe MR with 85% sensitivity and 87% specificity [area under the curve: 0.897, 95% confidence interval (CI): 0.781-0.999, P < 0.0001]. Logistic regression analysis revealed that DYS-PAP (odds ratio: 3.2, 95% CI: 1.22-47.7, P = 0.037) was the only independent predictor of moderate or moderate-to-severe functional MR. CONCLUSION: DYS-PAP is correlated with functional MR in non-ischaemic DCM patients with sinus rhythm. A DYS-PAP cut-off value of 30 ms is a useful tool to identify patients with moderate-to-severe functional MR. |
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Authors:
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Kursat Tigen; Tansu Karaahmet; Cihan Dundar; Ahmet Guler; Cihan Cevik; Ozcan Basaran; Cevat Kirma; Yelda Basaran |
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Publication Detail:
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Type: Journal Article Date: 2010-03-17 |
Journal Detail:
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Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: 11 ISSN: 1532-2114 ISO Abbreviation: Eur J Echocardiogr Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: England |
Other Details:
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Languages: eng Pagination: 671-6 Citation Subset: IM |
Affiliation:
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Cardiology Division, Kartal Kosuyolu Heart, Education and Research Hospital, Kartal Koşuyolu Kalp Egt. ve Arst. Hastanesi, Denizer Cad., Cevizli, Kartal, Istanbul, Turkey. mktigen@yahoo.com |
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Comment In:
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Eur J Echocardiogr. 2010 Oct;11(9):729; author reply 729-30
[PMID:
20558466
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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