scholarly journals Myxomatous Mitral Valve Disease with Mitral Valve Prolapse and Mitral Annular Disjunction: Clinical and Functional Significance of the Coincidence

2021 ◽  
Vol 8 (2) ◽  
pp. 9
Author(s):  
Nina C. Wunderlich ◽  
Siew Yen Ho ◽  
Nir Flint ◽  
Robert J. Siegel

The morphological changes that occur in myxomatous mitral valve disease (MMVD) involve various components, ultimately leading to the impairment of mitral valve (MV) function. In this context, intrinsic mitral annular abnormalities are increasingly recognized, such as a mitral annular disjunction (MAD), a specific anatomical abnormality whereby there is a distinct separation between the mitral annulus and the left atrial wall and the basal portion of the posterolateral left ventricular myocardium. In recent years, several studies have suggested that MAD contributes to myxomatous degeneration of the mitral leaflets, and there is growing evidence that MAD is associated with ventricular arrhythmias and sudden cardiac death. In this review, the morphological characteristics of MAD and imaging tools for diagnosis will be described, and the clinical and functional aspects of the coincidence of MAD and myxomatous MVP will be discussed.

2016 ◽  
Vol 37 (5) ◽  
pp. 3115 ◽  
Author(s):  
Marlos Gonçalves Sousa ◽  
Fabio Nelson Gava ◽  
Jorge Cardoso da Silva Filho ◽  
Sheila Nogueira Saraiva da Silva ◽  
Rafael Rodrigues Camacho ◽  
...  

Ventricular systolic dynamics involves the contraction of transverse and longitudinal myocardial fibers. Unfortunately, only the activity of the transverse myocardial fibers is foreseen by the standard systolic echocardiographic parameters. Although strain and strain rate have been used to assess the radial, circumferential and longitudinal planes of cardiac contraction, such analysis requires advanced equipment which is not always available in veterinary medicine. On the contrary, some unusual parameters may be recorded via standard methodology, allowing for the specific evaluation of left ventricular longitudinal contractility. In this study, the longitudinal contractile activity was evaluated using the long-axis fractional shortening and the mitral annulus motion, which were compared with several standard echocardiographic parameters in 14 beagles, including seven with asymptomatic mitral valve disease. The long-axis fractional shortening was positively correlated with both the mitral annulus motion and the end-diastolic left-ventricular diameter. Also, a significant correlation was found to exist between the mitral annulus motion and the left-ventricular end-diastolic diameter, which is likely supportive of its preload dependency. Even though no difference was documented in either mitral annulus motion or long-axis fractional shortening between healthy dogs and dogs with mitral valve disease, the latter only included animals with minimal cardiac remodeling, with no overt compromise of systolic function. Since it is possible to obtain these two parameters with any echocardiographic equipment, their inclusion in the routine exam would probably add information regarding the activity of the longitudinal myocardial fibers, whose functional deterioration supposedly occurs prior to the impairment of transverse fibers.


2021 ◽  
Vol 31 (1) ◽  
pp. 66-75
Author(s):  
Maria-Magdalena Gurzun ◽  
Monica Rosca ◽  
Andreea Calin ◽  
Carmen Beladan ◽  
Marinela Serban ◽  
...  

Myxomatous mitral valve disease (MVD) is a common disorder in which the entire mitral valve apparatus seems to be involved. Mitral valve repair is nowadays the method of choice for the correction of mitral regurgitation but the optimal shape and flexibility of the annuloplasty ring remain controversial. Considering that myxomatous MVD covers a wide spectrum from limited fi bro-elastic deficiency to extensive Barlow disease, we presume that the mitral annulus morphological and functional changes are likely different in different types of myxomatous MVD. We analyze the 3-dimensional geometry and the dynamics of the mitral annulus in 110 patients with significant mitral regurgitation due to different types of myxomatous mitral valve disease and 40 normal subjects using 3D transesophageal echocardiography. The mitral annulus differs in patients with limited MVD, extensive MVD and in normal controls in terms of size, shape, and dynamics. Patients with limited MVD have larger, flatter, dysfunctional and more mobile mitral annulus compared to normal, while patients with extensive MVD have even larger, fl atter and more dysfunctional mitral annulus, with reduced mobility. The non-planar dynamics has different patterns during systole, according to the extension of MV disease. Our data may be important for the appropriate choose of annuloplasty mitral annulus in mitral valve repair, the current trend being to choose the ring according to the underlying pathology.


2020 ◽  
Vol 316 ◽  
pp. 205-206
Author(s):  
Bilge Duran Karaduman ◽  
Hüseyin Ayhan ◽  
Telat Keleş ◽  
Engin Bozkurt

2013 ◽  
Vol 27 (4) ◽  
pp. 875-883 ◽  
Author(s):  
N.E. Zois ◽  
N.T. Olsen ◽  
S.G. Moesgaard ◽  
C.E. Rasmussen ◽  
T. Falk ◽  
...  

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