Ischemic mitral regurgitation was associated with significantly greater maximum mitral leaflet tenting length compared to controls (9.8 vs 3.1 mm, p<0.0001) using 3D echocardiography.
Case-Control (n=22)
Can transthoracic real-time three-dimensional echocardiography quantify geometric changes and valve tenting in patients with ischemic mitral regurgitation compared to controls?
Real-time 3D echocardiography effectively quantifies the geometric deformity and tenting of the mitral valve in ischemic mitral regurgitation, providing detailed anatomical insights for surgical planning.
Absolute Event Rate: 9.8% vs 3.1%
p-value: p=<0.0001
OBJECTIVES: We sought to investigate the geometric changes of the mitral leaflets and annulus, clarify the maximum tenting site of the leaflets, and quantify the valve tenting in ischemic mitral regurgitation (MR) using three-dimensional (3D) echocardiography. BACKGROUND: Although the understanding of the mechanisms of ischemic MR has advanced recently, the geometric changes of the mitral leaflets and annulus have been assessed by two-dimensional echocardiography in the clinical setting, despite the unique configuration of the leaflets and annulus. METHODS: Utilizing real-time 3D echocardiography, we obtained transthoracic volumetric images in 12 patients with ischemic MR presenting with global left ventricular dysfunction and in 10 controls. Original software was used to crop the 3D data into 18 radial planes, and we marked the mitral annulus and leaflets in each plane in mid-systole. The 3D images of the leaflets and annulus were reconstructed for the quantitative measurements. RESULTS: In ischemic MR, the annulus flattened with apparent tenting of the leaflets. Maximum and mean tenting length were longer and tenting volume was larger in ischemic MR than control subjects (maximum tenting length: 9.8 +/- 2.0 mm vs. 3.1 +/- 1.2 mm, p < 0.0001, mean tenting length: 3.7 +/- 0.9 mm vs. 0.7 +/- 0.5 mm, p < 0.0001, tenting volume: 4.09 +/- 1.22 ml vs. 0.45 +/- 0.29 ml, p < 0.0001). The maximum tenting site was located in anterior leaflet in all patients. CONCLUSIONS: We clearly demonstrated 3D geometric deformity of the mitral leaflets and annulus in ischemic MR using novel software for creating images by 3D echocardiography. This technique will be helpful in making a proper decision for the surgical strategy in each patient.
Watanabe et al. (Thu,) conducted a case-control in Ischemic mitral regurgitation (n=22). Ischemic mitral regurgitation vs. Controls was evaluated on Maximum tenting length (p=<0.0001). Ischemic mitral regurgitation was associated with significantly greater maximum mitral leaflet tenting length compared to controls (9.8 vs 3.1 mm, p<0.0001) using 3D echocardiography.