Left Ventricular Strain in Chronic Ischemic Mitral Regurgitation in Relation to Mitral Tethering Pattern

Gelsomino, Sandro; Garsse, Leen van; Lucà, Fabiana; Parise, Orlando; Cheriex, Emile C.; Rao, Carmelo Massimiliano; Gensini, Gian Franco

doi:10.1016/j.echo.2013.01.011

Cited by 12 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, annular dilation alone without leaflet tethering is an uncommon cause of significant secondary mitral regurgitation, such as in patients with left atrium dilatation from long-standing atrial fibrillation [ 26 ]. Furthermore, tethering angles define the geometrical relationship between the base of the leaflets to the annulus: α represents the angle between the annular plane and AML and β the angle between the annular plane and PML [ 27 , 28 ]. Despite poor inter-modality agreement, a higher ratio of posterior to anterior angle—describing an asymmetric tenting phenotype—has been reported as a predictor of increased mitral regurgitation severity [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort

Ricci

Aung

Gallina

et al. 2021

Journal of Cardiovascular Magnetic Resonance

View full text Add to dashboard Cite

Background Mitral valve (MV) and tricuspid valve (TV) apparatus geometry are essential to define mechanisms and etiologies of regurgitation and to inform surgical or transcatheter interventions. Given the increasing use of cardiovascular magnetic resonance (CMR) for the evaluation of valvular heart disease, we aimed to establish CMR-derived age- and sex-specific reference values for mitral annular (MA) and tricuspid annular (TA) dimensions and tethering indices derived from truly healthy Caucasian adults. Methods 5065 consecutive UK Biobank participants underwent CMR using cine balanced steady-state free precession imaging at 1.5 T. Participants with non-Caucasian ethnicity, prevalent cardiovascular disease and other conditions known to affect cardiac chamber size and function were excluded. Absolute and indexed reference ranges for MA and TA diameters and tethering indices were stratified by gender and age (45–54, 55–64, 65–74 years). Results Overall, 721 (14.2%) truly healthy participants aged 45–74 years (54% women) formed the reference cohort. Absolute MA and TA diameters, MV tenting length and MV tenting area, were significantly larger in men. Mean ± standard deviation (SD) end-diastolic and end-systolic MA diameters in the 3-chamber view (anteroposterior diameter) were 2.9 ± 0.4 cm (1.5 ± 0.2 cm/m2) and 3.3 ± 0.4 cm (1.7 ± 0.2 cm/m2) in men, and 2.6 ± 0.4 cm (1.6 ± 0.2 cm/m2) and 3.0 ± 0.4 cm (1.8 ± 0.2 cm/m2) in women, respectively. Mean ± SD end-diastolic and end-systolic TA diameters in the 4-chamber view were 3.2 ± 0.5 cm (1.6 ± 0.3 cm/m2) and 3.2 ± 0.5 cm (1.7 ± 0.3 cm/m2) in men, and 2.9 ± 0.4 cm (1.7 ± 0.2 cm/m2) and 2.8 ± 0.4 cm (1.7 ± 0.3 cm/m2) in women, respectively. With advancing age, end-diastolic TA diameter became larger and posterior MV leaflet angle smaller in both sexes. Reproducibility of measurements was good to excellent with an inter-rater intraclass correlation coefficient (ICC) between 0.92 and 0.98 and an intra-rater ICC between 0.90 and 0.97. Conclusions We described age- and sex-specific reference ranges of MA and TA dimensions and tethering indices in the largest validated healthy Caucasian population. Reference ranges presented in this study may help to improve the distinction between normal and pathological states, prompting the identification of subjects that may benefit from advanced cardiac imaging for annular sizing and planning of valvular interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort

Ricci

Aung

Gallina

et al. 2021

Journal of Cardiovascular Magnetic Resonance

View full text Add to dashboard Cite

show abstract

“…LV strain has been assessed in chronic MR, 40 in dilated cardiomyopathy, 41 and after mitral surgery. 42 Only one recent study dealt with LV 2D strain after MV repair with the clip device.…”

Section: Left Ventricular Function After Clip Implantationmentioning

confidence: 99%

Assessment of Biventricular Function by Three-Dimensional Speckle-Tracking Echocardiography in Secondary Mitral Regurgitation after Repair with the MitraClip System

Vitarelli

Madon

Capotosto

et al. 2015

Journal of the American Society of Echocardiography

View full text Add to dashboard Cite

“… Data from: Zeng et al [ 12 , 22 ]; Gelsomino et al [ 23 ]; Veronesi et al [ 19 ]; Agricola et al [ 7 ]. …”

Section: Introductionmentioning

confidence: 99%

“…The tethering angles define the relationship of the base of the leaflets to the annulus: α represents the angle between annular plane and anterior mitral leaflet and β the angle between annular plane and posterior mitral leaflet [ 23 ]. 3D TTE and TEE acquisition of volumetric data sets allows selection of particular imaging slices to calculate tethering angles [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic assessment of ischemic mitral regurgitation

Dudzinski

Hung

2014

Cardiovasc Ultrasound

View full text Add to dashboard Cite

Ischemic mitral regurgitation is an important consequence of LV remodeling after myocardial infarction. Echocardiographic diagnosis and assessment of ischemic mitral regurgitation are critical to gauge its adverse effects on prognosis and to attempt to tailor rational treatment strategy. There is no single approach to the echocardiographic assessment of ischemic mitral regurgitation: standard echocardiographic measures of mitral regurgitation severity and of LV dysfunction are complemented by assessments of displacement of the papillary muscles and quantitative indices of mitral valve deformation. Development of novel approaches to understand mitral valve geometry by echocardiography may improve understanding of the mechanism, clinical trajectory, and reparability of ischemic mitral regurgitation.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-7120-12-46) contains supplementary material, which is available to authorized users.

show abstract

Left Ventricular Strain in Chronic Ischemic Mitral Regurgitation in Relation to Mitral Tethering Pattern

Cited by 12 publications

References 33 publications

Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort

Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort

Assessment of Biventricular Function by Three-Dimensional Speckle-Tracking Echocardiography in Secondary Mitral Regurgitation after Repair with the MitraClip System

Echocardiographic assessment of ischemic mitral regurgitation

Contact Info

Product

Resources

About