In Vivo Measurement of Mitral Leaflet Surface Area and Subvalvular Geometry in Patients With Asymmetrical Septal Hypertrophy
Key result
Indexed total mitral leaflet area (adjusted OR 5.651; 95% CI 1.573-20.304; P=0.008) and inter-papillary muscle distance were independent determinants of LVOT obstruction in septal hypertrophy.
Why the study?
Does abnormal mitral valve and papillary muscle geometry contribute to LVOT obstruction in patients with asymmetrical septal hypertrophy?
Population
79 subjects, including 47 patients with asymmetrical septal hypertrophy and 32 normal controls.
Comparison
Real-time 3-dimensional echocardiography with… vs Normal controls and comparison between…
Design
Cross-sectional
Authors
Discussion
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Implication
Larger mitral leaflet area and papillary muscle displacement independently predict obstruction in asymmetrical septal hypertrophy; leaves open whether 3D metrics should guide individualized therapy.
Study Design
Type
Observational (n=79)
Structured PICO
Does abnormal mitral valve and papillary muscle geometry contribute to LVOT obstruction in patients with asymmetrical septal hypertrophy?
P
Population
79 individuals, comprising 47 patients with asymmetrical septal hypertrophy (20 with resting LVOT obstruction and 27 without) and 32 normal controls, evaluated using real-time 3-dimensional echocardiography.
E
Exposure
Real-time 3-dimensional echocardiography with customized software (Omni 4D) analysis of mitral leaflet area and subvalvular geometry
C
Comparator
Normal controls (n=32) and comparison between hypertrophy patients with vs without LVOT obstruction
O
Outcome
Determinants of LVOT obstruction and minimal LVOT area during systolesurrogate
Main Result
Odds Ratio: 5.651 (95% CI 1.573–20.304)
p-value: p=0.008
Primary changes of the mitral apparatus, including increased mitral leaflet area and papillary muscle displacement, are independent determinants of LVOT obstruction in asymmetrical septal hypertrophy.
Cite This Study
Kim et al. (2010) conducted an observational in Asymmetrical septal hypertrophy (n=79). Indexed total mitral leaflet area vs. Normal controls and patients without LVOT obstruction was evaluated on Left ventricular outflow tract (LVOT) obstruction (adjusted OR 5.651, 95% CI 1.573 to 20.304, p=0.008). Indexed total mitral leaflet area (adjusted OR 5.651; 95% CI 1.573-20.304; P=0.008) and inter-papillary muscle distance were independent determinants of LVOT obstruction in septal hypertrophy.