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Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation: real-time three-dimensional echocardiography studyBACKGROUND: This study was conducted to elucidate the geometric differences of the mitral apparatus in patients with significant mitral regurgitation caused by ischemic cardiomyopathy (ICM-MR) and by idiopathic dilated cardiomyopathy (DCM-MR) by use of real-time 3D echocardiography (RT3DE). METHODS AND RESULTS: Twenty-six patients with ICM-MR caused by posterior infarction, 18 patients with DCM-MR, and 8 control subjects were studied. With the 3D software, commissure-commissure plane and 3 perpendicular anteroposterior (AP) planes were generated for imaging the medial, central, and lateral sides of the mitral valve (MV) during mid systole. In 3 AP planes, the angles between the annular plane and each leaflet (anterior, Aalpha; posterior, Palpha) were measured. In ICM-MR, Aalpha measured in the medial and central planes was significantly larger than that in the lateral plane (39+/-5 degrees, 34+/-6 degrees, and 27+/-5 degrees, respectively; P<0.01), whereas Palpha showed no significant difference in any of the 3 AP planes (61+/-7 degrees, 57+/-7 degrees, and 56+/-7 degrees, P>0.05). In DCM-MR, both Aalpha (38+/-8 degrees, 37+/-9 degrees, and 36+/-7 degrees, P>0.05) and Palpha (59+/-6 degrees, 58+/-5 degrees, and 57+/-6 degrees, P>0.05) revealed no significant differences in the 3 planes. CONCLUSIONS: The pattern of MV deformation from the medial to the lateral side was asymmetrical in ICM-MR, whereas it was symmetrical in DCM-MR. RT3DE is a helpful tool for differentiating the geometry of the mitral apparatus between these 2 different types of functional mitral regurgitation.
Document ID
20040087811
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Kwan, Jun
(The Cleveland Clinic Foundation Cleveland, Ohio 44195, United States)
Shiota, Takahiro
Agler, Deborah A.
Popovic, Zoran B.
Qin, Jian Xin
Gillinov, Marc A.
Stewart, William J.
Cosgrove, Delos M.
McCarthy, Patrick M.
Thomas, James D.
Date Acquired
August 21, 2013
Publication Date
March 4, 2003
Publication Information
Publication: Circulation
Volume: 107
Issue: 8
ISSN: 0009-7322
Subject Category
Life Sciences (General)
Distribution Limits
Public
Copyright
Other
Keywords
Evaluation Studies
Non-NASA Center
NASA Discipline Cardiopulmonary

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