Mitral annulus size links ventricular dilatation to functional mitral regurgitation

Zoran B. Popović, Maureen Martin, Kiyotaka Fukamachi, Masahiro Inoue, Jun Kwan, Kazuyoshi Doi, Xin Qin Jian, Takahiro Shiota, Mario J. Garcia, Patrick M. McCarthy, James D. Thomas*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


We compared the impact of annulus size and valve deformation (tethering) on mitral regurgitation in the animal dilated cardiomyopathy model, and assessed if acute left ventricular volume changes affect mitral annulus dimensions. We performed 3-dimensional echocardiography in 30 open-chest dogs with pacing-induced cardiomyopathy. Mitral annulus area was calculated from its two orthogonal diameters, whereas valve tethering was quantified by valve tenting area measurement. Mitral valve regurgitant volume showed the highest correlation with annulus area (r = 0.64, P < .001), left atrial volume (r = 0.40, P < .01), and left ventricular end-diastolic volume (r = 0.37, P < .01). Regurgitant volume showed poorer correlation with valve tethering in both septolateral and intercommissural planes (r = 0.35 and r = 0.31, P < .05 for both). Annulus dimensions correlated with acute changes of left ventricular end-diastolic volume (r = 0.68, P = .002). Mitral annulus dilation is the strongest predictor of functional mitral regurgitation in this animal dilated cardiomyopathy model.

Original languageEnglish (US)
Pages (from-to)959-963
Number of pages5
JournalJournal of the American Society of Echocardiography
Issue number9
StatePublished - Sep 2005

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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