Simplified echocardiographic measurement of the mitral anulus

Vijayaraghavan, G; Boltwood, Chester M.; Tei, Chuwa; Wong, Maylene; Shah, Pravin M.

doi:10.1016/0002-8703(86)90310-8

Cited by 41 publications

(19 citation statements)

References 25 publications

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“…14,15 Mitral annular areas were obtained from mitral annular dimensions in apical long-axis, four-chamber, and two-chamber views, using an ellipsoid assumption. 16 Recurrent MR was the insufficiency 2þ at follow-up appointments in patients with no/trivial MR at discharge.…”

Section: Mitral Regurgitationmentioning

confidence: 99%

Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation

Gelsomino

Lorusso²,

Cicco³

et al. 2007

European Heart Journal

117

102

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AimsWe present 5-year echocardiographic results of combined undersizing mitral ring annuloplasty (UMRA) and coronary artery bypass grafting (CABG) in chronic ischaemic mitral regurgitation (CIMR). Methods and resultsTwo hundred and fifty-one patients (aged 68.4 + 8.1, 62.5% male) undergoing combined CABG and UMRA in our Institution (Cardiac Surgery, Careggi Hospital, Florence, Italy) between September 2001 and March 2007 were prospectively enrolled in the study. Median follow up was 32.9 months [interquartile range (IQR) 17.5-51.6]. Fourteen patients with significant residual mitral regurgitation (MR) needing immediate intraoperative revision (n ¼ 3) or at discharge (n ¼ 11) were excluded from the study. Serial echocardiograms were performed in 220 survivors at baseline, discharge, and annually thereafter. Additionally, 17 patients died (2 early and 15 late deaths) and were also excluded from the study. MR remained stable at 1 year and re-increased at 3 years (P , 0.001) and 5 years (P , 0.001). Fiveyear actuarial survival was 83.2 + 4.4. Five-year freedom from re-operation for failed repair was 78.2 + 4.9%. Mean systolic and diastolic diameters decreased significantly at discharge (P ¼ 0.001 and P ¼ 0.01, respectively) and at early follow up (P ¼ 0.004 and P ¼ 0.02) but raised at 3 years (P , 0.001) and 5 years (P , 0.001). Systolic and diastolic sphericity indexes improved at discharge (P , 0.001) remained stable at 1 year but they re-increased at 3-year control (P ¼ 0.006 and P ¼ 0.03, respectively) with a late raise exceeding the pre-operative value (P , 0.001). Left ventricular reverse remodelling was observed in 44.2% of the study population with 10.3% of patients showing further left ventricular dilatation. At multivariable model, end-systolic volume 145 mL, systolic sphericity index 0.7, myocardial performance index 0.9, and wall motion score index 1.5 were predictors of recurrent MR. ConclusionOur findings emphasize the need for improved repair technique and better patient selection to identify patients with anticipated repair failure who could benefit more from valve replacement or other procedure directly addressing ventricular tethering.--

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Section: Mitral Regurgitationmentioning

confidence: 99%

Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation

Gelsomino

Lorusso²,

Cicco³

et al. 2007

European Heart Journal

117

102

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“…10 The mitral annulus was visualized and its dimensions were measured from the left ventricular apex in 2 orthogonal planes including midsystolic apical 4-and 2-chamber views (Fig 1). 11,12 The tricuspid annulus was also visualized from the right ventricular apex in 2 orthogonal planes including the 4-chamber view. 13,14 The mitral and tricuspid annuli were identified as the hinge points of the leaflets defined by their insertion on the left or right ventricular walls.…”

mentioning

confidence: 99%

“…13,14 The mitral and tricuspid annuli were identified as the hinge points of the leaflets defined by their insertion on the left or right ventricular walls. 15 The mid-systolic mitral and tricuspid annular area 12 was obtained by elliptical assumption (area = d1×d2× /4) (Fig 1). Color Doppler flow mapping was performed to evaluate regurgitant jet flow in the same view with the transducer position and direction slightly modified to obtain the largest regurgitant jet.…”

mentioning

confidence: 99%

Impact of Atrial Fibrillation on Tricuspid and Mitral Annular Dilatation and Valvular Regurgitation.

Zhou

Otsuji

Shiro

et al. 2002

Circ J

Self Cite

122

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“…15, 16 The mitral leaflet-tenting area between the leaflets and the line connecting the annular hinge points in the apical 4-chamber view was traced at midsystole to estimate the apical displacement of the mitral leaflets ( Figure 1B). 17 The leaflet-tethering distance between the PM tips and the contralateral anterior mitral annulus was also measured in the apical 4-and 2-chamber views (Figure 1, L1 and L2) to estimate PM displacement.…”

Section: Echocardiographic Measurementsmentioning

confidence: 99%

Mechanism of Mitral Regurgitation in the Acute Phase of Inferior Wall Myocardial Infarction - Reduced Closing Force as a Consequence of Left Ventricular Systolic Dysfunction in the Presence of Tethering as a Determinant of Mitral Regurgitation -

Hong

Kim

Hur

et al. 2011

Circ J

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Background:To delineate the mechanism of mitral regurgitation (MR) in the acute phase of inferior wall myocardial infarction (MI). Methods and Results:In 97 patients (age 59±12 years) with acute inferior wall MI, the severity of MR, left ventricular (LV) geometric changes and function within 1.7±1.3 days after MI by echocardiography was retrospectively evaluated. Infarct size was measured within 3.9±1.7 days by cardiac magnetic resonance. Mild MR was present in 16 (16.5%) and moderate MR in 12 (12.4%) of 97 patients. There were no significant differences in mitral annular area, sphericity and distances between papillary muscle tips and the contralateral mitral annulus. However, patients with moderate MR had significantly larger LV end-systolic volume, tenting area and infarct size. There was a graded relationship between the severity of MR and LV ejection fraction. In a multivariable regression analysis, LV ejection fraction and tenting area were found to be independent predictors of the severity of MR (r 2 =0.180, P=0.001).Conclusions: MR was associated with LV systolic dysfunction, increase in end-systolic LV volume and tethering of mitral leaflet, suggesting reduced closing force as a consequence of LV systolic dysfunction in the presence of leaflet tethering would play a more pivotal role in the development of MR. (Circ J 2011; 75: 619 - 625)

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Simplified echocardiographic measurement of the mitral anulus

Cited by 41 publications

References 25 publications

Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation

Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation

Impact of Atrial Fibrillation on Tricuspid and Mitral Annular Dilatation and Valvular Regurgitation.

Mechanism of Mitral Regurgitation in the Acute Phase of Inferior Wall Myocardial Infarction - Reduced Closing Force as a Consequence of Left Ventricular Systolic Dysfunction in the Presence of Tethering as a Determinant of Mitral Regurgitation -

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