Geometric predictor of significant mitral regurgitation in patients with severe ischemic cardiomyopathy, undergoing Dor procedure: a real-time 3D echocardiographic study

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
Jun KwanT Shiota

Abstract

Significant mitral regurgitation (MR) is frequently associated with coronary artery disease. The precise geometric predictors of significant MR in ischemic cardiomyopathy are not clearly defined. We performed real-time 3D echocardiography (RT3DE) in 48 patients scheduled for infarct exclusion surgery or Dor procedure, 22 of whom had moderate or severe MR (DorMR) and 26 with no or trivial MR (DorNoMR). Two orthogonal apical volumetric planes of LV, commissure-commissure (CC) and antero-posterior (AP) planes, were generated during mid-systole. Mitral valve tenting height (MVTht) and area (MVTa) were measured. The degree of leaflet tethering was estimated by the angles between the annular plane and each leaflet (anterior leaflet: Aalpha, posterior leaflet: Palpha). MVTht (1.11+/-0.14 vs 0.78+/-0.20 cm, P<0.01) and MVTa (1.30+/-0.34 vs 0.87+/-0.27 cm(2), P<0.01) were significantly larger in DorMR compared with DorNoMR. In DorMR, both Aalpha (38+/-6 vs 31+/-7 degrees , P<0.01) and Palpha (60+/-7 vs 41+/-8 degrees , P<0.01) significantly increased more than those in DorNoMR. Multiple logistic regression analysis found Palpha to be the most important geometric predictor of significant MR. MV tenting area was found to be the strongest ...Continue Reading

Citations

Jun 5, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jan I Poelaert, Stefaan Bouchez
Sep 3, 2010·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Masaki IzumoPatrizio Lancellotti
Dec 18, 2016·The Journal of Thoracic and Cardiovascular Surgery·Shuiyun Wang, Bing Tang
Oct 16, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Takahiro Shiota
Nov 8, 2014·The Korean Journal of Internal Medicine·Takahiro Shiota

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