Progressive Loss of Miral Annular Saddle Shape Occurs as Chronic Ischemic Mitral Regurgitation Develops

2006 ◽  
Vol 12 (6) ◽  
pp. S24-S25
Author(s):  
Liam P. Ryan ◽  
Benjamin M. Jackson ◽  
Landi M. Parish ◽  
Hirotsugu Hamamoto ◽  
Martin G. St. John Sutton ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Ischemic Mitral Regurgitation ◽  
Progressive Loss ◽  
Chronic Ischemic Mitral Regurgitation ◽  
Saddle Shape

scholarly journals Annular Geometry in Patients With Chronic Ischemic Mitral Regurgitation

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Shuichiro Kaji ◽  
Michihiro Nasu ◽  
Atsushi Yamamuro ◽  
Kazuaki Tanabe ◽  
Kunihiko Nagai ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Animal Studies ◽  
Mitral Annulus ◽  
Ischemic Mitral Regurgitation ◽  
Width Ratio ◽  
3D Geometry ◽  
Annular Geometry ◽  
Chronic Ischemic Mitral Regurgitation ◽  
Saddle Shape ◽  
Best Fit

Background— Although animal studies showed that annular remodeling may be related to the pathogenesis of chronic ischemic mitral regurgitation (CIMR), little was known in humans. A better understanding of the precise 3D geometry of the mitral valvular-ventricular complex in CIMR is needed to devise a better surgical technique. The purpose of the study was to elucidate mitral annular geometry in patients with CIMR using cardiac MRI. Methods and Results— Thirty-eight patients with previous inferior or posterior myocardial infarction were studied. With the 3D reconstruction of the mitral annulus and subvalvular apparatus from a series of longitudinal cine MRIs, end-systolic mitral annulus dimensions and 3D geometry were calculated. Patients were grouped by mitral regurgitation grade using echocardiography (≥2+, n=15 versus ≤1+, n=23). Both septal-lateral and commissure-commissure mitral annular diameters were significantly greater in CIMR(+) patients (35±5 versus 30±4 mm, P =0.005; 46±6 versus 39±4 mm, P <0.001, respectively). The length of the fibrous annulus was significantly larger in CIMR(+) patients (28±3 versus 24±3 mm; P <0.001). The height of the annular “saddle horn” above a best-fit plane was lower in CIMR(+) patients (4.2±1.2 versus 6.0±1.8 mm; P =0.002), and the annular height to commissural width ratio was significantly lower in CIMR(+) patients (12±3 versus 21±5%; P <0.001). Conclusions— Patients with CIMR had greater septal-lateral and commissure-commissure mitral annular dimension, larger intertrigonal distance, and flattened saddle shape of mitral annulus. These associated geometric alterations may be important in the pathogenesis of CIMR.

Outcomes of Mitral Valve Repair for Chronic Ischemic Mitral Regurgitation

2009 ◽  
Vol 17 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Lokeswara R Sajja ◽  
Gopichand Mannam ◽  
Bhaskara R S Dandu ◽  
Satyendranath Pathuri ◽  
Sriramulu Sompalli ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Ischemic Mitral Regurgitation ◽  
Valve Repair ◽  
Chronic Ischemic Mitral Regurgitation

Mitral tetrahedron as a geometrical surrogate for chronic ischemic mitral regurgitation

2005 ◽  
Vol 289 (3) ◽  
pp. H1218-H1225 ◽  
Author(s):  
Hsi-Yu Yu ◽  
Mao-Yuan Su ◽  
Yih-Sharng Chen ◽  
Fang-Yue Lin ◽  
Wen-Yih Isaac Tseng
Keyword(s):  
Mitral Regurgitation ◽  
Surface Area ◽  
Left Ventricular ◽  
Ischemic Mitral Regurgitation ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Area Index ◽  
Ventricular Ejection Fraction ◽  
Cutoff Values ◽  
Chronic Ischemic Mitral Regurgitation

The present study tests the hypothesis that a mitral tetrahedron (MT) is a useful geometrical surrogate for assessment of chronic ischemic mitral regurgitation (CIMR). Fifty-eight subjects were divided into three groups on the basis of left ventricular ejection fraction (LVEF) and the presence or absence of CIMR: LVEF ≥0.5 and negative CIMR ( group 1, n = 28), LVEF <0.5 and negative CIMR ( group 2, n = 12), and LVEF <0.5 and positive CIMR ( group 3, n = 18). MT was defined by its four vertices at the anterior annulus, posterior annulus, and medial and lateral papillary muscle roots, determined by MRI at peak systole. The results showed no clear cutoff values of MT parameters between groups 2 and 1. In contrast, all MT indexes were significantly different between groups 3 and 2 ( P < 0.05), and significant cutoff values differentiated the two groups. A scoring system employing parameters of the whole MT confirmed the absence of CIMR with total edge length index <268 mm/BSA1/3, total surface area index <2,528 mm2/BSA2/3, and volume index <5,089 mm3/BSA (where BSA is body surface area). The sensitivity, specificity, and positive and negative predictive values were 1.00. This preliminary study demonstrates that MT might serve as a good geometrical surrogate for assessing CIMR. The derived geometrical criteria of MT may be useful in surgical correction of CIMR.

scholarly journals Echocardiographically based treatment of chronic ischemic mitral regurgitation

2011 ◽  
Vol 141 (5) ◽  
pp. 1150-1156.e1 ◽  
Author(s):  
Antonio M. Calafiore ◽  
Angela L. Iacò ◽  
Antonio Bivona ◽  
Egidio Varone ◽  
Salvo Scandura ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Ischemic Mitral Regurgitation ◽  
Chronic Ischemic Mitral Regurgitation

scholarly journals Acute Versus Chronic Ischemic Mitral Regurgitation

2018 ◽  
Vol 11 (4) ◽  
Author(s):  
Shun Nishino ◽  
Nozomi Watanabe ◽  
Toshiyuki Kimura ◽  
Nehiro Kuriyama ◽  
Yoshisato Shibata
Keyword(s):  
Mitral Regurgitation ◽  
Ischemic Mitral Regurgitation ◽  
Chronic Ischemic Mitral Regurgitation
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