scholarly journals Mitral Annular and Left Ventricular Dynamics in Atrial Functional Mitral Regurgitation: A Three-Dimensional and Speckle-Tracking Echocardiographic Study

2019 ◽  
Vol 32 (4) ◽  
pp. 503-513 ◽  
Author(s):  
Zhe Tang ◽  
Yi-Ting Fan ◽  
Yu Wang ◽  
Chun-Na Jin ◽  
Ka-Wai Kwok ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Speckle Tracking ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Echocardiographic Study ◽  
Ventricular Dynamics

scholarly journals Torsion Mechanics as an Indicator of More Advanced Left Ventricular Systolic Dysfunction in Secondary Mitral Regurgitation in Patients with Dilated Cardiomyopathy: A 2D Speckle-Tracking Analysis

Cardiology ◽  
2018 ◽  
Vol 139 (3) ◽  
pp. 187-196 ◽  
Author(s):  
Elena Kinova ◽  
Natalia Spasova ◽  
Angelina Borizanova ◽  
Assen Goudev
Keyword(s):  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Speckle Tracking ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Compensatory Mechanism ◽  
Structural Wall ◽  
Group 2 ◽  
Group 1

Left ventricular (LV) twist serves as a compensatory mechanism in systolic dysfunction and its degree of reduction may reflect a more advanced stage of disease. Aim: The aim was to investigate twist alterations depending on the degree of functional mitral regurgitation (MR) by speckle-tracking echocardiography. Methods: Sixty-three patients with symptomatic dilated cardiomyopathy (DCM) were included. Patients were divided according to MR vena contracta width (VCW): group 1 with VCW <7 mm (mild/moderate MR) and group 2 with VCW ≥7 mm (severe MR). Results: There were no differences in LV geometry and function between groups. Group 2 showed lower endocardial basal rotation (BR) (–2.04° ± 1.83° vs. –3.23° ± 1.83°, p = 0.012); epicardial BR (–1.54° ± 1.18° vs. –2.31° ± 1.22°, p = 0.015); endocardial torsion (0.41°/cm ± 0.36°/cm vs. 0.63°/cm ± 0.44°/cm, p = 0.033) and mid-level circumferential strain (CSmid) (–6.12% ± 2.64% vs. –7.75% ± 2.90%, p = 0.028), when compared with group 1. Multivariable linear regression analysis identified endocardial BR, torsion and CSmid, as the best predictors of larger VCW. In the ROC curve analysis, endocardial BR and CSmid values greater than or equal to –3.63° and –9.35%, respectively, can differentiate patients with severe MR. Conclusions: In DCM patients, torsional profile was more altered in severe MR. Endocardial BR, endocardial torsion, and CSmid, can be used as indicators of advanced structural wall architecture damage.

Abstract 3385: Role Of Regional Geometric Dyssynchrony By Real-time Three-dimensional Echocardiography As A Determinant Of Functional Mitral Regurgitation In Patients With Acute Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Chung-Lieh Hung ◽  
Anil Verma ◽  
Rahman Shah ◽  
Charles Jia-Yin Hou ◽  
Hung-I Yeh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Real Time ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Acute Mi ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Background: Functional mitral regurgitation (FMR) after myocardial infarction (MI) is associated with left ventricular (LV) dys-synchrony and increased mortality. However, determinants of FMR severity after acute MI are poorly defined. Our aim was (1) to test whether real-time Three-Dimensional echocardiography (RT-3DE) can provide insights into the mechanism of LV dys-synchrony on MR severity after MI (2) to investigate role of selective regional dys-synchrony index (DI) in prediction of FMR. Method: RT-3DE and Doppler echo was performed on 64 consecutive patients (mean age 62.2 ± 12.5 yrs) following acute MI without cardiogenic shock and with narrow QRS complex (< 120 ms). MR Severity was assessed by vena contracta, and MR jet area/LA area. Dyssynchrony index (DI) was derived from the dispersion of time to minimum regional volume for all 16 LV segments. Pearson’s correlation and multiple linear regression analysis were used to identify the relationship between FMR and DI. Different models of LV dys-synchrony including global index and selective ring-defined (basal, middle and apical ring) regional index were all analyzed and compared. Results: The mean LVEF was 49.6 ± 11.9% and LV end-diastolic volume (EDV) was 93.1 ± 23.8ml. All regional and global DIs were significantly correlated with FMR even after adjusting for age, LVEF and EDV (table 1 ), with mid-wall DI being most strongly associated with MR severity. Conclusion: RT-3DE determined mid-wall DI following MI is strongly associated with FMR. Our results suggest that selective geometric ring-defined DI has better FMR severity prediction and may provide specific approaches to the treatment of FMR complicating MI.

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