Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitation
Abstract Background Atrial fibrillation (AF) can result in atrial functional mitral regurgitation (MR), but the mechanism remains controversial. Few data about the relationship between the 3-dimensional morphology of the MV and the degree of MR in AF exist. Methods Real-time 3-dimensional transesoph...
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | Cardiovascular Ultrasound |
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| Online Access: | http://link.springer.com/article/10.1186/s12947-018-0131-1 |
| _version_ | 1828735401697738752 |
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| author | Tao Cong Jinping Gu Alex Pui-Wai Lee Zhijuan Shang Yinghui Sun Qiaobing Sun Hong Wei Na Chen Siyao Sun Tingting Fu |
| author_facet | Tao Cong Jinping Gu Alex Pui-Wai Lee Zhijuan Shang Yinghui Sun Qiaobing Sun Hong Wei Na Chen Siyao Sun Tingting Fu |
| author_sort | Tao Cong |
| collection | DOAJ |
| description | Abstract Background Atrial fibrillation (AF) can result in atrial functional mitral regurgitation (MR), but the mechanism remains controversial. Few data about the relationship between the 3-dimensional morphology of the MV and the degree of MR in AF exist. Methods Real-time 3-dimensional transesophageal echocardiography (3D-TEE) of the MV was acquired in 168 patients with AF (57.7% persistent AF), including 25 (14.9%) patients with moderate to severe MR (the MR+ group) and 25 patients without AF as controls. The 3-dimensional geometry of the MV apparatus was acquired using dedicated quantification software. Results Compared with the group of patients with no or mild MR (the MR- group) and the controls, the MR+ group had a larger left atrium (LA), a more dilated mitral annulus (MA), a reduced annular height to commissural width ratio (AHCWR), indicating flattening of the annular saddle shape, and greater leaflet surfaces and tethering. MR severity was correlated with the MA area (r2 = 0.43, P < 0.01) and the annulus circumference (r2 = 0.38, P < 0.01). A logistic regression analysis indicated that the MA area (OR: 1.02, 95% CI: 1.01–1.03, P < 0.01), AHCWR (OR: 0.24, 95% CI: 0.14–0.35, P = 0.04) and MV tenting volume (OR: 3.24, 95% CI: 1.16–9.08, P = 0.03) were independent predictors of MR severity in AF patients. Conclusions The mechanisms of “atrial functional MR” are complex and include dilation of the MA, flattening of the annular saddle shape and greater leaflet tethering. |
| first_indexed | 2024-04-12T23:06:14Z |
| format | Article |
| id | doaj.art-d80ba4a522c743ab8b3fe6f9493dd380 |
| institution | Directory Open Access Journal |
| issn | 1476-7120 |
| language | English |
| last_indexed | 2024-04-12T23:06:14Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Ultrasound |
| spelling | doaj.art-d80ba4a522c743ab8b3fe6f9493dd3802022-12-22T03:12:55ZengBMCCardiovascular Ultrasound1476-71202018-08-0116111010.1186/s12947-018-0131-1Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitationTao Cong0Jinping Gu1Alex Pui-Wai Lee2Zhijuan Shang3Yinghui Sun4Qiaobing Sun5Hong Wei6Na Chen7Siyao Sun8Tingting Fu9Department of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Intensive Care Unit, The Second Affiliated Hospital of Dalian Medical UniversityDivision of Cardiology, Department of Medicine and Therapeutics, The Prince of Wales Hospital of Chinese University of Hong KongDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityAbstract Background Atrial fibrillation (AF) can result in atrial functional mitral regurgitation (MR), but the mechanism remains controversial. Few data about the relationship between the 3-dimensional morphology of the MV and the degree of MR in AF exist. Methods Real-time 3-dimensional transesophageal echocardiography (3D-TEE) of the MV was acquired in 168 patients with AF (57.7% persistent AF), including 25 (14.9%) patients with moderate to severe MR (the MR+ group) and 25 patients without AF as controls. The 3-dimensional geometry of the MV apparatus was acquired using dedicated quantification software. Results Compared with the group of patients with no or mild MR (the MR- group) and the controls, the MR+ group had a larger left atrium (LA), a more dilated mitral annulus (MA), a reduced annular height to commissural width ratio (AHCWR), indicating flattening of the annular saddle shape, and greater leaflet surfaces and tethering. MR severity was correlated with the MA area (r2 = 0.43, P < 0.01) and the annulus circumference (r2 = 0.38, P < 0.01). A logistic regression analysis indicated that the MA area (OR: 1.02, 95% CI: 1.01–1.03, P < 0.01), AHCWR (OR: 0.24, 95% CI: 0.14–0.35, P = 0.04) and MV tenting volume (OR: 3.24, 95% CI: 1.16–9.08, P = 0.03) were independent predictors of MR severity in AF patients. Conclusions The mechanisms of “atrial functional MR” are complex and include dilation of the MA, flattening of the annular saddle shape and greater leaflet tethering.http://link.springer.com/article/10.1186/s12947-018-0131-1Atrial fibrillationMitral regurgitationThree-dimensional transesophageal echocardiography |
| spellingShingle | Tao Cong Jinping Gu Alex Pui-Wai Lee Zhijuan Shang Yinghui Sun Qiaobing Sun Hong Wei Na Chen Siyao Sun Tingting Fu Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitation Cardiovascular Ultrasound Atrial fibrillation Mitral regurgitation Three-dimensional transesophageal echocardiography |
| title | Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitation |
| title_full | Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitation |
| title_fullStr | Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitation |
| title_full_unstemmed | Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitation |
| title_short | Quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real-time 3-dimensional echocardiography atrial functional mitral regurgitation |
| title_sort | quantitative analysis of mitral valve morphology in atrial functional mitral regurgitation using real time 3 dimensional echocardiography atrial functional mitral regurgitation |
| topic | Atrial fibrillation Mitral regurgitation Three-dimensional transesophageal echocardiography |
| url | http://link.springer.com/article/10.1186/s12947-018-0131-1 |
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