Key result
Ischemic MR post-MI linked to mitral annulus dilatation and pronounced P3 deformity following inferior MI.
Why the study?
Segmental mitral annulus deformity and regurgitation after ischemic damage from myocardial infarction are poorly understood.
Does real-time 3D echocardiography identify specific patterns of mitral annulus deformity in patients with ischemic mitral regurgitation post-MI compared to normal controls?
Case-Control (n=92)
Does real-time 3D echocardiography identify specific patterns of mitral annulus deformity in patients with ischemic mitral regurgitation post-MI compared to normal controls?
Real-time 3D echocardiography demonstrates that ischemic mitral regurgitation post-MI is associated with global mitral annulus dilation, with specific asymmetric P3 segment deformity occurring after inferior MI.
OBJECTIVE: The three-dimensional (3D) saddle shape of the mitral annulus (MA) is well characterized in humans, but segmental MA deformity and regurgitation suffered after the ischemic damage of myocardial infarction (MI) is poorly understood. In this study, such changes were assessed in patients with ischemic mitral regurgitation (IMR) post-MI, using our computerized 3D echo technique. METHODS: A patient cohort (n = 72) with IMR due to inferior or anterior MI and normal controls (n = 20) were enrolled for 3D MA echo studies. Sequential coordinates of MA were manually measured from each of 18 radial planes, cropped in midsystole, to generate 3D MA images. In addition, six segmental (A1, A2, A3, P1, P2, P3) parameters of MA and global features, such as circumference, area, and height, were calculated. RESULTS: All six segments of MA were significantly dilated in the IMR group compared with corresponding segments of normal controls. Although there were no significant intragroup differences in A1, A2, and A3 segments, a greater degree of P3 segmental MA deformity was observed only in patients following inferior MI. CONCLUSION: The MA dilatation observed in patients with IMR after MI was more pronounced in patients with anterior versus inferior MI. However, P3 segmental dilatation of MA was significantly greater in patients after inferior IM with significant IMR, corresponding with more severe asymmetric MA deformity. (Echocardiography 2012;29:42-50).
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Baosheng et al. (2011) conducted a case-control in Ischemic mitral regurgitation post-myocardial infarction (n=92). Ischemic mitral regurgitation post-myocardial infarction vs. Normal controls was evaluated on Mitral annulus segmental and global deformity. Ischemic mitral regurgitation post-MI was associated with significant mitral annulus dilatation compared to controls, with pronounced P3 segmental deformity specifically following inferior MI.
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