Cargando…

Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation

BACKGROUND: Transcatheter mitral valve replacement (TMVR) is a new therapeutic option for high surgical risk patients with mitral regurgitation (MR). Mitral valve (MV) geometry quantification is of paramount importance for success of the procedure and transthoracic 3D echocardiography represents a u...

Descripción completa

Detalles Bibliográficos
Autores principales: Aruta, Patrizia, Muraru, Denisa, Guta, Andrada Camelia, Mihaila, Sorina, Ruozi, Niccolò, Palermo, Chiara, Elnagar, Basma, Iliceto, Sabino, Badano, Luigi P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186037/
https://www.ncbi.nlm.nih.gov/pubmed/30314517
http://dx.doi.org/10.1186/s12947-018-0145-8
_version_ 1783362794991648768
author Aruta, Patrizia
Muraru, Denisa
Guta, Andrada Camelia
Mihaila, Sorina
Ruozi, Niccolò
Palermo, Chiara
Elnagar, Basma
Iliceto, Sabino
Badano, Luigi P.
author_facet Aruta, Patrizia
Muraru, Denisa
Guta, Andrada Camelia
Mihaila, Sorina
Ruozi, Niccolò
Palermo, Chiara
Elnagar, Basma
Iliceto, Sabino
Badano, Luigi P.
author_sort Aruta, Patrizia
collection PubMed
description BACKGROUND: Transcatheter mitral valve replacement (TMVR) is a new therapeutic option for high surgical risk patients with mitral regurgitation (MR). Mitral valve (MV) geometry quantification is of paramount importance for success of the procedure and transthoracic 3D echocardiography represents a useful screening tool. Accordingly, we sought to asses MV geometry in patients with functional MR (FMR) that would potentially benefit of TMVR, focusing on the comparison of mitral annulus (MA) geometry between patients with ischemic (IMR) and non ischemic mitral regurgitation (nIMR). METHODS: We retrospectively selected 94 patients with severe FMR: 41 (43,6%) with IMR and 53 (56,4%) with nIMR. 3D MA analysis was performed on dedicated transthoracic 3D data sets using a new, commercially-available software package in two moments of the cardiac cycle (early-diastole and mid-systole). We measured MA dimension and geometry parameters, left atrial and left ventricular volumes. RESULTS: Maximum (MA area 10.7 ± 2.5 cm(2) vs 11.6 ± 2.7 cm(2), p > 0.05) and the best fit plane MA area (9.9 ± 2.3 cm(2) vs 10.7 ± 2.5 cm(2), p > 0.05, respectively) were similar between IMR and nIMR. nIMR patients showed larger mid-systolic 3D area (9.8 ± 2.3 cm(2) vs 10.8 ± 2.7 cm(2), p < 0.05) and perimeter (11.2 ± 1.3 cm vs 11.8 ± 1.5 cm, p < 0.05) with longer and larger leaflets, and wider aorto-mitral angle (135 ± 10° vs 141 ± 11°, p < 0.05). Conversely, the area of MA at the best fit plane did not differ between IMR and nIMR patients (9 ± 1.1 cm(2) vs 9.9 ± 1.5 cm(2), p > 0.05). CONCLUSIONS: Patients with ischemic and non-ischemic etiology of FMR have similar maximum dimension, yet systolic differences between the two groups should be taken into account to tailor prosthesis’s selection. TRIAL REGISTRATION: N.A.
format Online
Article
Text
id pubmed-6186037
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-61860372018-10-19 Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation Aruta, Patrizia Muraru, Denisa Guta, Andrada Camelia Mihaila, Sorina Ruozi, Niccolò Palermo, Chiara Elnagar, Basma Iliceto, Sabino Badano, Luigi P. Cardiovasc Ultrasound Research BACKGROUND: Transcatheter mitral valve replacement (TMVR) is a new therapeutic option for high surgical risk patients with mitral regurgitation (MR). Mitral valve (MV) geometry quantification is of paramount importance for success of the procedure and transthoracic 3D echocardiography represents a useful screening tool. Accordingly, we sought to asses MV geometry in patients with functional MR (FMR) that would potentially benefit of TMVR, focusing on the comparison of mitral annulus (MA) geometry between patients with ischemic (IMR) and non ischemic mitral regurgitation (nIMR). METHODS: We retrospectively selected 94 patients with severe FMR: 41 (43,6%) with IMR and 53 (56,4%) with nIMR. 3D MA analysis was performed on dedicated transthoracic 3D data sets using a new, commercially-available software package in two moments of the cardiac cycle (early-diastole and mid-systole). We measured MA dimension and geometry parameters, left atrial and left ventricular volumes. RESULTS: Maximum (MA area 10.7 ± 2.5 cm(2) vs 11.6 ± 2.7 cm(2), p > 0.05) and the best fit plane MA area (9.9 ± 2.3 cm(2) vs 10.7 ± 2.5 cm(2), p > 0.05, respectively) were similar between IMR and nIMR. nIMR patients showed larger mid-systolic 3D area (9.8 ± 2.3 cm(2) vs 10.8 ± 2.7 cm(2), p < 0.05) and perimeter (11.2 ± 1.3 cm vs 11.8 ± 1.5 cm, p < 0.05) with longer and larger leaflets, and wider aorto-mitral angle (135 ± 10° vs 141 ± 11°, p < 0.05). Conversely, the area of MA at the best fit plane did not differ between IMR and nIMR patients (9 ± 1.1 cm(2) vs 9.9 ± 1.5 cm(2), p > 0.05). CONCLUSIONS: Patients with ischemic and non-ischemic etiology of FMR have similar maximum dimension, yet systolic differences between the two groups should be taken into account to tailor prosthesis’s selection. TRIAL REGISTRATION: N.A. BioMed Central 2018-10-12 /pmc/articles/PMC6186037/ /pubmed/30314517 http://dx.doi.org/10.1186/s12947-018-0145-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Aruta, Patrizia
Muraru, Denisa
Guta, Andrada Camelia
Mihaila, Sorina
Ruozi, Niccolò
Palermo, Chiara
Elnagar, Basma
Iliceto, Sabino
Badano, Luigi P.
Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation
title Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation
title_full Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation
title_fullStr Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation
title_full_unstemmed Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation
title_short Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation
title_sort comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186037/
https://www.ncbi.nlm.nih.gov/pubmed/30314517
http://dx.doi.org/10.1186/s12947-018-0145-8
work_keys_str_mv AT arutapatrizia comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT murarudenisa comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT gutaandradacamelia comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT mihailasorina comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT ruoziniccolo comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT palermochiara comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT elnagarbasma comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT ilicetosabino comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation
AT badanoluigip comparisonofmitralannulusgeometrybetweenpatientswithischemicandnonischemicfunctionalmitralregurgitationimplicationsfortranscathetermitralvalveimplantation