Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation: Real-time three-dimensional echocardiography study

Jun Kwan, Takahiro Shiota*, Deborah A. Agler, Zoran B. Popović, Jian Xin Qin, Marc A. Gillinov, William J. Stewart, Delos M. Cosgrove, Patrick M. McCarthy, James D. Thomas

*Corresponding author for this work

Research output: Contribution to journalArticle

285 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1135-1140
Number of pages6
JournalCirculation
Volume107
Issue number8
DOIs
StatePublished - Mar 4 2003

Keywords

  • Cardiomyopathy
  • Echocardiography
  • Mitral valve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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