Key result
Patients with organic mitral regurgitation had reduced global mitral annulus curvature and torsion compared to normals, which improved following surgical mitral valve repair.
Why the study?
Does mitral valve repair improve global and regional mitral annulus curvature and torsion in patients with organic mitral regurgitation compared to normal controls?
Observational (n=30)
Does mitral valve repair improve global and regional mitral annulus curvature and torsion in patients with organic mitral regurgitation compared to normal controls?
Novel 3D echocardiography parameters of mitral annulus curvature and torsion can quantify geometric changes in organic mitral regurgitation and their correction following mitral valve repair.
May aid quantification of annular changes in organic MR; extends 3D echo applications but remains hypothesis-generating.
AIMS: The mitral annulus (MA) saddle shape is complex but vital for a normal functioning mitral apparatus. Although conventional parameters of MA geometry such as area and height are helpful, they fall short of describing its complex regional geometry. METHODS AND RESULTS: In this prospective study, novel parameters of MA curvature and torsion were derived from three-dimensional (3D) transoesophageal echocardiography. These quantitative indices were computed in 15 patients with normal valves (age 53 ± 8 years) and in 15 patients with organic significant mitral regurgitation (MR, age 66 ± 11 years), before and after mitral valve repair (MVR). The MA was traced and modelled in mid- and end-systole. Curvature and torsion were computed at 500 points across the MA to derive regional and global indices. Overall, patients with organic MR presented the smallest global curvature and torsion; this decrease in curvature and torsion reflects a loss of tonicity of the MA tissue. These changes were largely corrected with MVR surgery, to higher values, compared with normals. The regional analysis revealed similar trends. The maximal MA curvature was found to be at the MA 'anterior horn', whereas the MA 'posterior horn' had the lowest curvature values. CONCLUSION: Novel MA parameters of curvature and torsion can be computed from 3D echocardiography and provide quantitative characteristics of dynamic regional MA geometry. In patients with organic MR, the reduced regional and global curvatures improve following surgical MVR. These quantitative parameters may help further refine the quantitative description of MA geometry in various mitral valve pathologies and after MVR.
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Zekry et al. (2015) conducted an observational in Organic significant mitral regurgitation (n=30). Organic mitral regurgitation and mitral valve repair vs. Normal valves and baseline was evaluated on Mitral annulus curvature and torsion. Patients with organic mitral regurgitation had reduced global mitral annulus curvature and torsion compared to normals, which improved following surgical mitral valve repair.
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