Geometry of Tricuspid Valve Apparatus in Patients with Mitral Regurgitation due to Fibroelastic Deficiency versus Barlow Disease: A Real-Time Three-dimensional Transesophageal Echocardiography Study

Hirasawa, Kensuke; Izumo, Masaki; Umemoto, Takuya; Suzuki, Kazuhiro; Kitanaka, Yosuke; Oi, Keiji; Mizuno, Tomohiro; Harada, Tomoo; Ashikaga, Takashi; Miyairi, Takeshi; Arai, Hirokuni; Hirao, Kazuyuki; Akashi, Yoshihiro

doi:10.1016/j.echo.2020.04.019

Cited by 6 publications

(2 citation statements)

References 40 publications

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“…This phenomenon implies that athletes prone to more excessive dilation of the MA are susceptible to a more pronounced TA remodeling. Of note, it has been suggested that alterations in TA geometry can be present even in the case of degenerative processes affecting the MA primarily (16). The mitral valve apparatus also shows a distinct change in shape if we compare the two athlete groups: although in athletes with MR, the parameters referring to the MA saddle shape, namely, annulus height to commissural width ratio (AHCWR) and nonplanar angle, were comparable with the values of sedentary controls, increased AHCWR and a less obtuse nonplanar angle were found in athletes without MR.…”

Section: Discussionmentioning

confidence: 99%

Geometrical remodeling of the mitral and tricuspid annuli in response to exercise training: a 3-D echocardiographic study in elite athletes

Fábián

Lakatos

Tokodi

et al. 2021

American Journal of Physiology-Heart and Circulatory Physiology

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Intense exercise exposes the heart to significant hemodynamic demands, resulting in adaptive changes in cardiac morphology and function. Nevertheless, the athletic adaptation of the atrioventricular valves remains to be elucidated. Our study aimed to characterize the geometry of mitral (MA) and tricuspid (TA) annuli in elite athletes using 3D echocardiography. Thirty-four athletes presented with functional mitral regurgitation (FMR) were retrospectively identified and compared to 34 athletes without MR, and 34 healthy, sedentary volunteers. 3DE datasets were used to quantify MA and TA geometry and leaflet tenting by dedicated softwares. MA and TA areas, as well as tenting volumes, were higher in athletes compared to controls. MA area was significantly higher in athletes with MR compared to those without (8.2±1.0 vs. 7.2±1.0cm2/m2, p<0.05). Interestingly, athletes with MR also presented with a significantly higher TA area (7.2±1.1 vs. 6.5±1.1cm2/m2, p<0.05). Non-planar angle describing the MA's saddle shape was less obtuse in athletes without MR, whereas the values of athletes with MR were comparable to controls. The exercise-induced relative increases in left ventricular (35±25%) and left atrial (40±29%) volumes were similar; however, the increment in the MA area was disproportionately higher (63±23%, overall p<0.001). The relative increase in TA area (40±23%) was also higher compared to the increment in right ventricular volume (34±25%, p<0.05). Atrioventricular annuli undergo a disproportionate remodeling in response to regular exercise. Athletic adaptation is characterized by both annular enlargement and increased leaflet tenting of both valves. There are differences in MA geometry in athletes presented with versus without FMR.

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Section: Discussionmentioning

confidence: 99%

Geometrical remodeling of the mitral and tricuspid annuli in response to exercise training: a 3-D echocardiographic study in elite athletes

Fábián

Lakatos

Tokodi

et al. 2021

American Journal of Physiology-Heart and Circulatory Physiology

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show abstract

“…This phenomenon implies that athletes prone to more excessive dilation of the MA are susceptible to a more pronounced TA remodeling [4]. Of note, it has been suggested that alterations in TA geometry can be present even in the case of degenerative processes affecting the MA primarily [140].…”

Section: Tricuspid Valve Regurgitationmentioning

confidence: 99%

Mitral and Tricuspid Valve Disease in Athletes

Segreti

Celeski

Monticelli

et al. 2023

JCM

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Observing mitral or tricuspid valve disease in an athlete raises many considerations for the clinician. Initially, the etiology must be clarified, with causes differing depending on whether the athlete is young or a master. Notably, vigorous training in competitive athletes leads to a constellation of structural and functional adaptations involving cardiac chambers and atrioventricular valve systems. In addition, a proper evaluation of the athlete with valve disease is necessary to evaluate the eligibility for competitive sports and identify those requiring more follow-up. Indeed, some valve pathologies are associated with an increased risk of severe arrhythmias and potentially sudden cardiac death. Traditional and advanced imaging modalities help clarify clinical doubts, allowing essential information about the athlete’s physiology and differentiating between primary valve diseases from those secondary to training-related cardiac adaptations. Remarkably, another application of multimodality imaging is evaluating athletes with valve diseases during exercise to reproduce the sport setting and better characterize the etiology and valve defect mechanism. This review aims to analyze the possible causes of atrioventricular valve diseases in athletes, focusing primarily on imaging applications in diagnosis and risk stratification.

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Current management of tricuspid regurgitation: a focus on the spiral suspension approach

Eishi,

Matsumaru

et al. 2024

Gen Thorac Cardiovasc Surg

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Geometry of Tricuspid Valve Apparatus in Patients with Mitral Regurgitation due to Fibroelastic Deficiency versus Barlow Disease: A Real-Time Three-dimensional Transesophageal Echocardiography Study

Cited by 6 publications

References 40 publications

Geometrical remodeling of the mitral and tricuspid annuli in response to exercise training: a 3-D echocardiographic study in elite athletes

Geometrical remodeling of the mitral and tricuspid annuli in response to exercise training: a 3-D echocardiographic study in elite athletes

Mitral and Tricuspid Valve Disease in Athletes

Current management of tricuspid regurgitation: a focus on the spiral suspension approach

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