Relation of Mitral Annulus and Left Atrial Dysfunction to the Severity of Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy.
Sorina Mihaila Baldea,Denisa Muraru,Marcelo Haertel Miglioranza,Sabino Iliceto,Dragos Vinereanu,Luigi P. Badano +5 more
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TLDR
Patients with DCM and FMR have MA geometry remodeling and contractile dysfunction, correlated with the severity of FMR, and these results provide new insights that might help with better selection of patients for MV transcatheter procedures.Abstract:
Introduction and Objectives. Patients with dilated cardiomyopathy (DCM) and functional mitral regurgitation (FMR) present altered geometry and dynamics of the mitral annulus (MA). We aimed to further assess the relationship between the MA dysfunction, FMR severity, and LA dysfunction in patients with ischemic and nonischemic DCM by using three-dimensional transthoracic echocardiography (3DTTE). Methods. 56 patients (58 ± 17 years, 42 men) with DCM and FMR and 52 controls, prospectively enrolled, underwent 3DTTE dedicated for mitral valve (MV), LA, and left ventricle (LV) quantitative analysis. Results. Patients with FMR vs. controls presented increased MA size and sphericity during the entire systole, whereas MA fractional area change (MAFAC) and MA displacement were decreased (15 ± 5 vs. 28 ± 5%; and 5 ± 3 vs. 10 ± 2 mm, ). In patients with moderate/severe FMR, MA diameters correlated with PISA radius, EROA, and regurgitant volume (Rvol), as also did the MA area (with PISA radius, EROA, and Rvol: r = 0.48, r = 0.58, and r = 0.47, ). MAFAC correlated inversely with EROA and Rvol (r = −0.32 and r = −0.35, ), with both active and total LA emptying fractions and with LV ejection fraction as well. In a stepwise multivariate regression model, decreased MAFAC and increased LA volume independently predicted patients with severe FMR. Conclusions. Patients with DCM and FMR have MA geometry remodeling and contractile dysfunction, correlated with the severity of FMR. MA contractile dysfunction correlated with both LA and left LV pumps dysfunctions and predicted patients with severe FMR. Our results provide new insights that might help with better selection of patients for MV transcatheter procedures.read more
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Mitral Annulus Geometry and Dynamic Motion Changes in Patients With Aortic Regurgitation: A Three-Dimensional Transesophageal Echocardiographic Study.
TL;DR: The mitral annulus (MA) geometry and dynamic motion changes in patients with aortic regurgitation (AR) before and after aortIC valve replacement (AVR).
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The role of advanced multimodality imaging in chronic mitral regurgitation.
TL;DR: The purpose of this review is to provide an overview of the current multimodal imaging techniques that are useful in correctly assessing patients with MR and to help identify the patients who will benefit from early surgery.
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Left Atrial Volume Correlates with Mitral Annulus Size: An MDCT Study
Gabriel Cismaru,Iulia Valean,Mihnea Cantemir Zirbo,Alexandru Tirpe,Andrei Cismaru,Radu Rosu,Mihai Puiu,Lucian Muresan,Gabriel Gusetu,Ioan-Alxandru Minciuna,Cristian Marius Florea,Raluca Tomoaia,Dumitru Zdrenghea,Dana Pop +13 more
TL;DR: In this article, the authors used multidetector computed tomography (MDCT) and looked at patients who had a dilated left atrium, assessing if the mitral valve also dilates.
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The Impact of Atrial Fibrillation on All Heart Chambers Remodeling and Function in Patients with Dilated Cardiomyopathy—A Two- and Three-Dimensional Echocardiography Study
TL;DR: In this article , the impact of atrial fibrillation on cardiac structure and function, using comprehensive two-and three-dimensional echocardiography, was assessed via standard two-dimensional, speckle-tracking, and three-dimentional echoechography (3DE).
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Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation
Jean-François Obadia,David Messika-Zeitoun,Guillaume Leurent,Bernard Iung,Guillaume Bonnet,Nicolas Piriou,Thierry Lefèvre,Christophe Piot,Frédéric Rouleau,Didier Carrié,Mohammed Nejjari,Patrick Ohlmann,Florence Leclercq,Christophe Saint Etienne,Emmanuel Teiger,Lionel Leroux,Nicole Karam,Nicolas Michel,Martine Gilard,Erwan Donal,Jean-Noël Trochu,B. Cormier,Xavier Armoiry,Florent Boutitie,Delphine Maucort-Boulch,Cécile Barnel,Géraldine Samson,Patrice Guerin,Alec Vahanian,Nathan Mewton +29 more
TL;DR: Among patients with severe secondary mitral regurgitation, the rate of death or unplanned hospitalization for heart failure at 1 year did not differ significantly between patients who underwent percutaneous mitral‐valve repair in addition to receiving medical therapy and those who received medical therapy alone.