TY - JOUR
T1 - Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation
T2 - Real-time three-dimensional echocardiography study
AU - Kwan, Jun
AU - Shiota, Takahiro
AU - Agler, Deborah A.
AU - Popović, Zoran B.
AU - Qin, Jian Xin
AU - Gillinov, Marc A.
AU - Stewart, William J.
AU - Cosgrove, Delos M.
AU - McCarthy, Patrick M.
AU - Thomas, James D.
PY - 2003/3/4
Y1 - 2003/3/4
N2 - Background - This study was conducted to elucidate the geometric differences of the mitral apparatus in patients with significant mitral regurgitation caused by ischemic cardiomyopathy (ICM-MR) and by idiopathic dilated cardiomyopathy (DCM-MR) by use of real-time 3D echocardiography (RT3DE). Methods and Results - Twenty-six patients with ICM-MR caused by posterior infarction, 18 patients with DCM-MR, and 8 control subjects were studied. With the 3D software, commissure-commissure plane and 3 perpendicular anteroposterior (AP) planes were generated for imaging the medial, central, and lateral sides of the mitral valve (MV) during mid systole. In 3 AP planes, the angles between the annular plane and each leaflet (anterior, Aα; posterior, Pα) were measured. In ICM-MR, Aα measured in the medial and central planes was significantly larger than that in the lateral plane (39±5°, 34±6°, and 27±5°, respectively; P<0.01), whereas Pα showed no significant difference in any of the 3 AP planes (61±7°, 57±7°, and 56±7°, P>0.05). In DCM-MR, both Aα (38±8°, 37±9°, and 36±7°, P>0.05) and Pα (59±6°, 58±5°, and 57±6°, P>0.05) revealed no significant differences in the 3 planes. Conclusions - The pattern of MV deformation from the medial to the lateral side was asymmetrical in ICM-MR, whereas it was symmetrical in DCM-MR. RT3DE is a helpful tool for differentiating the geometry of the mitral apparatus between these 2 different types of functional mitral regurgitation.
AB - Background - This study was conducted to elucidate the geometric differences of the mitral apparatus in patients with significant mitral regurgitation caused by ischemic cardiomyopathy (ICM-MR) and by idiopathic dilated cardiomyopathy (DCM-MR) by use of real-time 3D echocardiography (RT3DE). Methods and Results - Twenty-six patients with ICM-MR caused by posterior infarction, 18 patients with DCM-MR, and 8 control subjects were studied. With the 3D software, commissure-commissure plane and 3 perpendicular anteroposterior (AP) planes were generated for imaging the medial, central, and lateral sides of the mitral valve (MV) during mid systole. In 3 AP planes, the angles between the annular plane and each leaflet (anterior, Aα; posterior, Pα) were measured. In ICM-MR, Aα measured in the medial and central planes was significantly larger than that in the lateral plane (39±5°, 34±6°, and 27±5°, respectively; P<0.01), whereas Pα showed no significant difference in any of the 3 AP planes (61±7°, 57±7°, and 56±7°, P>0.05). In DCM-MR, both Aα (38±8°, 37±9°, and 36±7°, P>0.05) and Pα (59±6°, 58±5°, and 57±6°, P>0.05) revealed no significant differences in the 3 planes. Conclusions - The pattern of MV deformation from the medial to the lateral side was asymmetrical in ICM-MR, whereas it was symmetrical in DCM-MR. RT3DE is a helpful tool for differentiating the geometry of the mitral apparatus between these 2 different types of functional mitral regurgitation.
KW - Cardiomyopathy
KW - Echocardiography
KW - Mitral valve
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UR - http://www.scopus.com/inward/citedby.url?scp=0037418163&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.0000053558.55471.2D
DO - 10.1161/01.CIR.0000053558.55471.2D
M3 - Article
C2 - 12615791
AN - SCOPUS:0037418163
SN - 0009-7322
VL - 107
SP - 1135
EP - 1140
JO - Circulation
JF - Circulation
IS - 8
ER -