Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation
Abstract Fundamento: The role of papillary muscle function in severe mitral regurgitation with preserved and reduced left ventricular ejection fraction and the method of choice to evaluate PM have still been the subjects of controversy. Objectives: To evaluate and compare papillary muscle function...
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Sociedade Brasileira de Cardiologia (SBC)
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2017000400339&lng=en&tlng=en |
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| author | Alev Kılıcgedik Gokhan Kahveci Ahmet Seyfeddin Gurbuz Can Yucel Karabay Ahmet Guler Suleyman Cagan Efe Soe Moe Aung Ugur Arslantas Serdar Demir Ibrahim Akin Izgi Cevat Kirma |
| author_facet | Alev Kılıcgedik Gokhan Kahveci Ahmet Seyfeddin Gurbuz Can Yucel Karabay Ahmet Guler Suleyman Cagan Efe Soe Moe Aung Ugur Arslantas Serdar Demir Ibrahim Akin Izgi Cevat Kirma |
| author_sort | Alev Kılıcgedik |
| collection | DOAJ |
| description | Abstract Fundamento: The role of papillary muscle function in severe mitral regurgitation with preserved and reduced left ventricular ejection fraction and the method of choice to evaluate PM have still been the subjects of controversy. Objectives: To evaluate and compare papillary muscle function in and between patients with severe degenerative and functional mitral regurgitation by using the free strain method. Methods: 64 patients with severe mitral regurgitation - 39 patients with degenerative mitral regurgitation (DMR group) and 25 patients with severe functional mitral regurgitation (FMR group) - and 30 control subjects (control group) were included in the study. Papillary muscle function was evaluated through the free strain method from apical four chamber images of the anterolateral papillary muscle (APM) and from apical three chamber images of the posteromedial papillary muscle (PPM). Global left ventricular longitudinal and circumferential strains were evaluated by applying 2D speckle tracking imaging. Results: Global left ventricular longitudinal strain (DMR group, -17 [-14.2/-20]; FMR group, -9 [-7/-10.7]; control group, -20 [-18/-21] p < 0.001), global left ventricular circumferential strain (DMR group, -20 [-14.5/-22.7]; FMR group, -10 [-7/-12]; control group, -23 [-21/-27.5] p < 0.001) and papillary musle strains (PPMS; DMR group, -30.5 [-24/-46.7]; FMR group, -18 [-12/-30]; control group; -43 [-34.5/-39.5] p < 0.001; APMS; DMR group, (-35 [-23.5/-43]; FMR group, -20 [-13.5/-26]; control group, -40 [-32.5/-48] p < 0.001) were significantly different among all groups. APMS and PPMS were highly correlated with LVEF (p < 0.001, p < 0.001; respectively), GLS (p < 0.001, p < 0.001; respectively) and GCS (p < 0.001, p < 0.00; respectively) of LV among all groups. No correlation was found between papillary muscle strains and effective orifice area (EOA) in both groups of severe mitral regurgitation. Conclusions: Measuring papillary muscle longitudinal strain by the free strain method is practical and applicable. Papillary muscle dysfunction plays a small role in severe MR due to degenerative or functional causes and papillary muscle functions in general seems to follow left ventricular function. PPM is the most affected PM in severe mitral regurgitation in both groups of DMR and FMR. |
| first_indexed | 2024-04-12T05:14:43Z |
| format | Article |
| id | doaj.art-7043c772e05d45ffbc1c1ceb4923f8fd |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-04-12T05:14:43Z |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-7043c772e05d45ffbc1c1ceb4923f8fd2022-12-22T03:46:40ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-4170108433934610.5935/abc.20170035S0066-782X2017000400339Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral RegurgitationAlev KılıcgedikGokhan KahveciAhmet Seyfeddin GurbuzCan Yucel KarabayAhmet GulerSuleyman Cagan EfeSoe Moe AungUgur ArslantasSerdar DemirIbrahim Akin IzgiCevat KirmaAbstract Fundamento: The role of papillary muscle function in severe mitral regurgitation with preserved and reduced left ventricular ejection fraction and the method of choice to evaluate PM have still been the subjects of controversy. Objectives: To evaluate and compare papillary muscle function in and between patients with severe degenerative and functional mitral regurgitation by using the free strain method. Methods: 64 patients with severe mitral regurgitation - 39 patients with degenerative mitral regurgitation (DMR group) and 25 patients with severe functional mitral regurgitation (FMR group) - and 30 control subjects (control group) were included in the study. Papillary muscle function was evaluated through the free strain method from apical four chamber images of the anterolateral papillary muscle (APM) and from apical three chamber images of the posteromedial papillary muscle (PPM). Global left ventricular longitudinal and circumferential strains were evaluated by applying 2D speckle tracking imaging. Results: Global left ventricular longitudinal strain (DMR group, -17 [-14.2/-20]; FMR group, -9 [-7/-10.7]; control group, -20 [-18/-21] p < 0.001), global left ventricular circumferential strain (DMR group, -20 [-14.5/-22.7]; FMR group, -10 [-7/-12]; control group, -23 [-21/-27.5] p < 0.001) and papillary musle strains (PPMS; DMR group, -30.5 [-24/-46.7]; FMR group, -18 [-12/-30]; control group; -43 [-34.5/-39.5] p < 0.001; APMS; DMR group, (-35 [-23.5/-43]; FMR group, -20 [-13.5/-26]; control group, -40 [-32.5/-48] p < 0.001) were significantly different among all groups. APMS and PPMS were highly correlated with LVEF (p < 0.001, p < 0.001; respectively), GLS (p < 0.001, p < 0.001; respectively) and GCS (p < 0.001, p < 0.00; respectively) of LV among all groups. No correlation was found between papillary muscle strains and effective orifice area (EOA) in both groups of severe mitral regurgitation. Conclusions: Measuring papillary muscle longitudinal strain by the free strain method is practical and applicable. Papillary muscle dysfunction plays a small role in severe MR due to degenerative or functional causes and papillary muscle functions in general seems to follow left ventricular function. PPM is the most affected PM in severe mitral regurgitation in both groups of DMR and FMR.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2017000400339&lng=en&tlng=enInsuficiência da Valva Mitral / diagnósticoInsuficiência da Valva Mitral / fisiopatologiaMúsculos Papilares / fisiopatologiaDiagnóstico por ImagemEcocardiografia / métodosFunção VentricularRemodelação Ventricular |
| spellingShingle | Alev Kılıcgedik Gokhan Kahveci Ahmet Seyfeddin Gurbuz Can Yucel Karabay Ahmet Guler Suleyman Cagan Efe Soe Moe Aung Ugur Arslantas Serdar Demir Ibrahim Akin Izgi Cevat Kirma Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation Arquivos Brasileiros de Cardiologia Insuficiência da Valva Mitral / diagnóstico Insuficiência da Valva Mitral / fisiopatologia Músculos Papilares / fisiopatologia Diagnóstico por Imagem Ecocardiografia / métodos Função Ventricular Remodelação Ventricular |
| title | Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation |
| title_full | Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation |
| title_fullStr | Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation |
| title_full_unstemmed | Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation |
| title_short | Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation |
| title_sort | papillary muscle free strain in patients with severe degenerative and functional mitral regurgitation |
| topic | Insuficiência da Valva Mitral / diagnóstico Insuficiência da Valva Mitral / fisiopatologia Músculos Papilares / fisiopatologia Diagnóstico por Imagem Ecocardiografia / métodos Função Ventricular Remodelação Ventricular |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2017000400339&lng=en&tlng=en |
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