Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort
Abstract Background Mitral valve (MV) and tricuspid valve (TV) apparatus geometry are essential to define mechanisms and etiologies of regurgitation and to inform surgical or transcatheter interventions. Given the increasing use of cardiovascular magnetic resonance (CMR) for the evaluation of valvul...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-12-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12968-020-00688-y |
| _version_ | 1827280336644472832 |
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| author | Fabrizio Ricci Nay Aung Sabina Gallina Filip Zemrak Kenneth Fung Giandomenico Bisaccia Jose Miguel Paiva Mohammed Y. Khanji Cesare Mantini Stefano Palermi Aaron M. Lee Stefan K. Piechnik Stefan Neubauer Steffen E. Petersen |
| author_facet | Fabrizio Ricci Nay Aung Sabina Gallina Filip Zemrak Kenneth Fung Giandomenico Bisaccia Jose Miguel Paiva Mohammed Y. Khanji Cesare Mantini Stefano Palermi Aaron M. Lee Stefan K. Piechnik Stefan Neubauer Steffen E. Petersen |
| author_sort | Fabrizio Ricci |
| collection | DOAJ |
| description | Abstract Background Mitral valve (MV) and tricuspid valve (TV) apparatus geometry are essential to define mechanisms and etiologies of regurgitation and to inform surgical or transcatheter interventions. Given the increasing use of cardiovascular magnetic resonance (CMR) for the evaluation of valvular heart disease, we aimed to establish CMR-derived age- and sex-specific reference values for mitral annular (MA) and tricuspid annular (TA) dimensions and tethering indices derived from truly healthy Caucasian adults. Methods 5065 consecutive UK Biobank participants underwent CMR using cine balanced steady-state free precession imaging at 1.5 T. Participants with non-Caucasian ethnicity, prevalent cardiovascular disease and other conditions known to affect cardiac chamber size and function were excluded. Absolute and indexed reference ranges for MA and TA diameters and tethering indices were stratified by gender and age (45–54, 55–64, 65–74 years). Results Overall, 721 (14.2%) truly healthy participants aged 45–74 years (54% women) formed the reference cohort. Absolute MA and TA diameters, MV tenting length and MV tenting area, were significantly larger in men. Mean ± standard deviation (SD) end-diastolic and end-systolic MA diameters in the 3-chamber view (anteroposterior diameter) were 2.9 ± 0.4 cm (1.5 ± 0.2 cm/m2) and 3.3 ± 0.4 cm (1.7 ± 0.2 cm/m2) in men, and 2.6 ± 0.4 cm (1.6 ± 0.2 cm/m2) and 3.0 ± 0.4 cm (1.8 ± 0.2 cm/m2) in women, respectively. Mean ± SD end-diastolic and end-systolic TA diameters in the 4-chamber view were 3.2 ± 0.5 cm (1.6 ± 0.3 cm/m2) and 3.2 ± 0.5 cm (1.7 ± 0.3 cm/m2) in men, and 2.9 ± 0.4 cm (1.7 ± 0.2 cm/m2) and 2.8 ± 0.4 cm (1.7 ± 0.3 cm/m2) in women, respectively. With advancing age, end-diastolic TA diameter became larger and posterior MV leaflet angle smaller in both sexes. Reproducibility of measurements was good to excellent with an inter-rater intraclass correlation coefficient (ICC) between 0.92 and 0.98 and an intra-rater ICC between 0.90 and 0.97. Conclusions We described age- and sex-specific reference ranges of MA and TA dimensions and tethering indices in the largest validated healthy Caucasian population. Reference ranges presented in this study may help to improve the distinction between normal and pathological states, prompting the identification of subjects that may benefit from advanced cardiac imaging for annular sizing and planning of valvular interventions. |
| first_indexed | 2024-04-24T08:35:09Z |
| format | Article |
| id | doaj.art-fd113a08520141af83b29f709b73b7ad |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2024-04-24T08:35:09Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-fd113a08520141af83b29f709b73b7ad2024-04-16T17:45:56ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2020-12-0123111310.1186/s12968-020-00688-yCardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohortFabrizio Ricci0Nay Aung1Sabina Gallina2Filip Zemrak3Kenneth Fung4Giandomenico Bisaccia5Jose Miguel Paiva6Mohammed Y. Khanji7Cesare Mantini8Stefano Palermi9Aaron M. Lee10Stefan K. Piechnik11Stefan Neubauer12Steffen E. Petersen13Department of Neuroscience, Imaging and Clinical Sciences, “G.D’Annunzio” UniversityWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonDepartment of Neuroscience, Imaging and Clinical Sciences, “G.D’Annunzio” UniversityWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonDepartment of Neuroscience, Imaging and Clinical Sciences, “G.D’Annunzio” UniversityWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonDepartment of Neuroscience, Imaging and Clinical Sciences, “G.D’Annunzio” UniversityDepartment of Neuroscience, Imaging and Clinical Sciences, “G.D’Annunzio” UniversityWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonDivision of Cardiovascular Medicine, NIHR BRC Oxford, Radcliffe Department of Medicine, University of OxfordDivision of Cardiovascular Medicine, NIHR BRC Oxford, Radcliffe Department of Medicine, University of OxfordWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonAbstract Background Mitral valve (MV) and tricuspid valve (TV) apparatus geometry are essential to define mechanisms and etiologies of regurgitation and to inform surgical or transcatheter interventions. Given the increasing use of cardiovascular magnetic resonance (CMR) for the evaluation of valvular heart disease, we aimed to establish CMR-derived age- and sex-specific reference values for mitral annular (MA) and tricuspid annular (TA) dimensions and tethering indices derived from truly healthy Caucasian adults. Methods 5065 consecutive UK Biobank participants underwent CMR using cine balanced steady-state free precession imaging at 1.5 T. Participants with non-Caucasian ethnicity, prevalent cardiovascular disease and other conditions known to affect cardiac chamber size and function were excluded. Absolute and indexed reference ranges for MA and TA diameters and tethering indices were stratified by gender and age (45–54, 55–64, 65–74 years). Results Overall, 721 (14.2%) truly healthy participants aged 45–74 years (54% women) formed the reference cohort. Absolute MA and TA diameters, MV tenting length and MV tenting area, were significantly larger in men. Mean ± standard deviation (SD) end-diastolic and end-systolic MA diameters in the 3-chamber view (anteroposterior diameter) were 2.9 ± 0.4 cm (1.5 ± 0.2 cm/m2) and 3.3 ± 0.4 cm (1.7 ± 0.2 cm/m2) in men, and 2.6 ± 0.4 cm (1.6 ± 0.2 cm/m2) and 3.0 ± 0.4 cm (1.8 ± 0.2 cm/m2) in women, respectively. Mean ± SD end-diastolic and end-systolic TA diameters in the 4-chamber view were 3.2 ± 0.5 cm (1.6 ± 0.3 cm/m2) and 3.2 ± 0.5 cm (1.7 ± 0.3 cm/m2) in men, and 2.9 ± 0.4 cm (1.7 ± 0.2 cm/m2) and 2.8 ± 0.4 cm (1.7 ± 0.3 cm/m2) in women, respectively. With advancing age, end-diastolic TA diameter became larger and posterior MV leaflet angle smaller in both sexes. Reproducibility of measurements was good to excellent with an inter-rater intraclass correlation coefficient (ICC) between 0.92 and 0.98 and an intra-rater ICC between 0.90 and 0.97. Conclusions We described age- and sex-specific reference ranges of MA and TA dimensions and tethering indices in the largest validated healthy Caucasian population. Reference ranges presented in this study may help to improve the distinction between normal and pathological states, prompting the identification of subjects that may benefit from advanced cardiac imaging for annular sizing and planning of valvular interventions.https://doi.org/10.1186/s12968-020-00688-yCardiovascular magnetic resonanceReference valuesMitral valveTricuspid valveAnnulusTenting area |
| spellingShingle | Fabrizio Ricci Nay Aung Sabina Gallina Filip Zemrak Kenneth Fung Giandomenico Bisaccia Jose Miguel Paiva Mohammed Y. Khanji Cesare Mantini Stefano Palermi Aaron M. Lee Stefan K. Piechnik Stefan Neubauer Steffen E. Petersen Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort Journal of Cardiovascular Magnetic Resonance Cardiovascular magnetic resonance Reference values Mitral valve Tricuspid valve Annulus Tenting area |
| title | Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort |
| title_full | Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort |
| title_fullStr | Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort |
| title_full_unstemmed | Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort |
| title_short | Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort |
| title_sort | cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions the uk biobank cohort |
| topic | Cardiovascular magnetic resonance Reference values Mitral valve Tricuspid valve Annulus Tenting area |
| url | https://doi.org/10.1186/s12968-020-00688-y |
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