Left ventricular shape is the primary determinant of functional mitral regurgitation in heart failure

Kono, Tatsuji; Sabbah, Hani N.; Rosman, Howard; Alam, Mohsin; Jafri, S. Hammad; Goldstein, Sidney

doi:10.1016/0735-1097(92)90455-v

Cited by 332 publications

(185 citation statements)

References 11 publications

Supporting

Mentioning

166

Contrasting

Unclassified

Order By: Relevance

“…Moreover, in the dilated spherical ventricle the papillary muscles are pulled apart, which results in incompetence of the mitral valve and the development of "functional mitral regurgitation" (41). First of all this causes the loss of forward blood flow, and secondly the regurgitant flow further overloads the ventricle.…”

Section: Changes In Left Ventricular Geometry and Architecturementioning

confidence: 99%

Prediction of Short-Term Outcomes in Patients With Idiopathic Dilated Cardiomyopathy Referred for Transplantation Using Standard Echocardiography and Strain Imaging

Jasaitytė

Dandel

Lehmkuhl

et al. 2009

Transplantation Proceedings

View full text Add to dashboard Cite

Section: Changes In Left Ventricular Geometry and Architecturementioning

confidence: 99%

Prediction of Short-Term Outcomes in Patients With Idiopathic Dilated Cardiomyopathy Referred for Transplantation Using Standard Echocardiography and Strain Imaging

Jasaitytė

Dandel

Lehmkuhl

et al. 2009

Transplantation Proceedings

View full text Add to dashboard Cite

“…O aparecimento de insuficiência valvar mitral moderada à importante, na fase avançada da ICC, agrava a disfunção ventricular e perpetua a insuficiência cardíaca (25) .…”

Section: Considerações Finaisunclassified

Estudo comparativo do anel valvar mitral e do ventrículo esquerdo na cardiomiopatia dilatada

Hueb¹,

Jatene²,

Moreira³

et al. 2001

Rev Bras Cir Cardiovasc

View full text Add to dashboard Cite

P M A, Mioto B M, Chabelmann R C, Oliveira S A -Estudo comparativo do anel valvar mitral e do ventrículo esquerdo na cardiomiopatia dilatada. Material e Métodos: Analisaram-se 68 corações humanos adultos, fixados, sendo 48 portadores de CMD de etiologia isquêmica ou idiopática, e 20 corações sem cardiopatia. Obteve-se imagens digitalizadas do perímetro do anel mitral, inserção da cúspide anterior e posterior e da porção fibrosa e muscular. Obteve-se também o perímetro interno do VE, distância do septo ao músculo papilar anterior e posterior, distância entre os músculos papilares, e extensão do septo interventricular.Resultados: A análise dos resultados demonstrou proporcionalidade, tanto da porção fibrosa (r 2 = 0.98), quanto da porção muscular (r 2 = 0.99) do anel em relação ao grau de dilatação da valva mitral. A regressão linear revelou que o perímetro de inserção das cúspides anterior (r 2 = 0.96) e posterior (r 2 =0.98) também guardam relação de proporcionalidade. Observou-se que a dilatação do VE ocorre de forma global e esférica em seus segmentos. Não se observou relação de proporcionalidade entre o grau de dilatação do anel mitral e do VE.Conclusão: Ao contrário do que se pensava, na CMD de etiologia isquêmica ou idiopática, a dilatação do anel mitral ocorre de forma proporcional e não apenas na sua porção posterior. Não é o grau de dilatação do VE que determina o grau de dilatação do anel mitral pois eles ocorrem de forma independente. Estas observações abrem novas perspectivas para as técnicas de correção da insuficiência valvar mitral na CMD.

show abstract

“…The myocardial performance index (MPI) was measured using the method described by Tei et al 19 Sphericity indexes were obtained at end diastole and end systole (SI D and SI S , respectively) as the volume of the left ventricle divided by the volume of a sphere with a diameter equal to the longest axis of the left ventricle measured in the apical view. 20 The wall motion score index (WMSI) was calculated according to a 17-segment model. 21 …”

Section: Global Left Ventricular Remodellingmentioning

confidence: 99%

Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation

Gelsomino

Lorusso²,

Cicco³

et al. 2007

European Heart Journal

117

102

View full text Add to dashboard Cite

AimsWe present 5-year echocardiographic results of combined undersizing mitral ring annuloplasty (UMRA) and coronary artery bypass grafting (CABG) in chronic ischaemic mitral regurgitation (CIMR). Methods and resultsTwo hundred and fifty-one patients (aged 68.4 + 8.1, 62.5% male) undergoing combined CABG and UMRA in our Institution (Cardiac Surgery, Careggi Hospital, Florence, Italy) between September 2001 and March 2007 were prospectively enrolled in the study. Median follow up was 32.9 months [interquartile range (IQR) 17.5-51.6]. Fourteen patients with significant residual mitral regurgitation (MR) needing immediate intraoperative revision (n ¼ 3) or at discharge (n ¼ 11) were excluded from the study. Serial echocardiograms were performed in 220 survivors at baseline, discharge, and annually thereafter. Additionally, 17 patients died (2 early and 15 late deaths) and were also excluded from the study. MR remained stable at 1 year and re-increased at 3 years (P , 0.001) and 5 years (P , 0.001). Fiveyear actuarial survival was 83.2 + 4.4. Five-year freedom from re-operation for failed repair was 78.2 + 4.9%. Mean systolic and diastolic diameters decreased significantly at discharge (P ¼ 0.001 and P ¼ 0.01, respectively) and at early follow up (P ¼ 0.004 and P ¼ 0.02) but raised at 3 years (P , 0.001) and 5 years (P , 0.001). Systolic and diastolic sphericity indexes improved at discharge (P , 0.001) remained stable at 1 year but they re-increased at 3-year control (P ¼ 0.006 and P ¼ 0.03, respectively) with a late raise exceeding the pre-operative value (P , 0.001). Left ventricular reverse remodelling was observed in 44.2% of the study population with 10.3% of patients showing further left ventricular dilatation. At multivariable model, end-systolic volume 145 mL, systolic sphericity index 0.7, myocardial performance index 0.9, and wall motion score index 1.5 were predictors of recurrent MR. ConclusionOur findings emphasize the need for improved repair technique and better patient selection to identify patients with anticipated repair failure who could benefit more from valve replacement or other procedure directly addressing ventricular tethering.--

show abstract

Left ventricular shape is the primary determinant of functional mitral regurgitation in heart failure

Abstract: These data indicate that transformation of left ventricular shape (increased chamber sphericity) is the most likely substrate for the development of functional mitral regurgitation.

Cited by 332 publications

References 11 publications

Prediction of Short-Term Outcomes in Patients With Idiopathic Dilated Cardiomyopathy Referred for Transplantation Using Standard Echocardiography and Strain Imaging

Prediction of Short-Term Outcomes in Patients With Idiopathic Dilated Cardiomyopathy Referred for Transplantation Using Standard Echocardiography and Strain Imaging

Estudo comparativo do anel valvar mitral e do ventrículo esquerdo na cardiomiopatia dilatada

Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation

Contact Info

Product

Resources

About