Morphological three-dimensional analysis of papillary muscles in borderline left ventricles

Forte, Marí Nieves Velasco; Nassar, Mohamed; Byrne, Nick; Vieira, Miguel Silva; Valverde, Israel; Ruijsink, Bram; Simpson, John; Hussain, Tariq

doi:10.1017/s1047951117000439

Cited by 4 publications

(2 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Left ventricular papillary muscles (PMs) are small myocardial structures and play a significant role in the functioning of the mitral valve (MV) and the left ventricle (LV) [ 1 ]. During systole, the PM contracts before the LV wall contracts, causing apposition of the MV leaflets and limiting the retrograde blood flow from the LV back into the left atrium.…”

Section: Introductionmentioning

confidence: 99%

Papillary Muscle Infarction by Cardiac MRI in Patients With Mitral Regurgitation

Hou,

Sun,

Wang

et al. 2024

Clinical Cardiology

View full text Add to dashboard Cite

BackgroundPapillary muscle (PM) infarction (PMI) detected by cardiac magnetic resonance imaging (CMR) is associated with poor outcomes. Whether PM parameters provide more value for mitral regurgitation (MR) management currently remains unclear. Therefore, we examined the prognostic value of PMI using CMR in patients with MR.MethodsBetween March 2018 and July 2023, we retrospectively enrolled 397 patients with MR undergoing CMR. CMR was used to detect PMI qualitatively and quantitively. We also collected baseline clinical, echocardiography, and follow‐up data.ResultsOf the 397 patients with MR (52.4 ± 13.9 years), 117 (29.5%) were assigned to the PMI group, with 280 (70.5%) in the non‐PMI group. PMI was demonstrated more in the posteromedial PM (PM‐PM, 98/117) than in the anterolateral PM (AL‐PM, 45/117). Compared with patients without PMI, patients with PMI had a decreased AL‐PM (41.5 ± 5.4 vs. 45.6 ± 5.3)/PM‐PM diastolic length (35.0 ± 5.2 vs. 37.9 ± 4.0), PM‐longitudinal strain (LS, 20.4 ± 6.1 vs. 24.9 ± 4.6), AL‐PM‐LS (19.7 ± 6.8 vs. 24.7 ± 5.6)/PM‐PM‐LS (21.2 ± 7.9 vs. 25.2 ± 6.0), and increased inter‐PM distance (25.7 ± 8.0 vs. 22.7 ± 6.2, all p < 0.001). Multiple logistic regression analyses identified male sex (odds ratio [OR] = 3.65, 95% confidence interval = 1.881−7.081, p < 0.001) diabetes mellitus (OR/95% CI/p = 2.534/1.13–5.68/0.024), AL‐PM diastolic length (OR/95% CI/p = 0.841/0.77–0.92/< 0.001), PM‐PM diastolic length (OR/95% CI/p = 0.873/0.79–0.964/0.007), inter‐PM distance (OR/95% CI/p = 1.087/1.028–1.15/0.003), AL‐PM‐LS (OR/95% CI/p = 0.892/0.843–0.94/< 0.001), and PM‐PM‐LS (OR/95% CI/p = 0.95/0.9–0.992/0.021) as independently associated with PMI. Over a 769 ± 367‐day follow‐up, 100 (25.2%) patients had arrhythmia. Cox regression analyses indicated that PMI (hazard ratio [HR]/95% CI/p = 1.644/1.062–2.547/0.026), AL‐PM‐LS (HR/95% CI/p = 0.937/0.903–0.973/0.001), and PM‐PM‐LS (HR/95% CI/p = 0.933/0.902–0.965/< 0.001) remained independently associated with MR.ConclusionsThe CMR‐derived PMI and LS parameters improve the evaluation of PM dysfunction, indicating a high risk for arrhythmia, and provide additive risk stratification for patients with MR.

show abstract

Section: Introductionmentioning

confidence: 99%

Papillary Muscle Infarction by Cardiac MRI in Patients With Mitral Regurgitation

Hou,

Sun,

Wang

et al. 2024

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…The left ventricular papillary muscles (PPMs) are intracavitary muscular structures arising from the ventricular wall, modulating the function of the mitral valve (MV) [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Papillary Muscle Involvement during Acute Myocardial Infarction: Detection by Cardiovascular Magnetic Resonance Using T1 Mapping Technique and Papillary Longitudinal Strain

Pambianchi

Giannetti

Marchitelli

et al. 2023

JCM

View full text Add to dashboard Cite

Papillary muscle (PPM) involvement in myocardial infarction (MI) increases the risk of secondary mitral valve regurgitation or PPM rupture and may be diagnosed using late gadolinium enhancement (LGE) imaging. The native T1-mapping (nT1) technique and PPM longitudinal strain (PPM-ls) have been used to identify PPM infarction (iPPM) without the use of the contrast agent. This study aimed to assess the diagnostic performance of nT1 and PPM-ls in the identification of iPPM. Forty-six patients, who performed CMR within 14–30 days after MI, were retrospectively enrolled: sixteen showed signs of iPPM on LGE images. nT1 values were measured within the infarcted area (IA), remote myocardium (RM), blood pool (BP), and anterolateral and posteromedial PPMs and compared using ANOVA. PPM-ls values have been assessed on cineMR images as the percentage of shortening between end-diastolic and end-systolic phases. Higher nT1 values and lower PPM-ls were found in infarcted compared to non-infarcted PPMs (nT1: 1219.3 ± 102.5 ms vs. 1052.2 ± 80.5 ms and 17.6 ± 6.3% vs. 21.6 ± 4.3%; p-value < 0.001 for both), with no significant differences between the nT1 of infarcted PPMs and IA and between the non-infarcted PPMs and RM. ROC analysis demonstrated an excellent discriminatory power for nT1 in detecting the iPPM (AUC = 0.874; 95% CI: 0.784–0.963; p < 0.001). nT1 and PPM-ls are valid tools in assessing iPPM with the advantage of avoiding contrast media administration.

show abstract

Morphological three-dimensional analysis of papillary muscles in borderline left ventricles

Abstract: The superolateral support can be shorter or absent in borderline or hypoplastic left ventricle cases. The papillary muscle pedicles in these patients often show a broad insertion. These changes have important implications on surgical options and should be described routinely.

Cited by 4 publications

References 17 publications

Papillary Muscle Infarction by Cardiac MRI in Patients With Mitral Regurgitation

Papillary Muscle Infarction by Cardiac MRI in Patients With Mitral Regurgitation

Papillary Muscle Involvement during Acute Myocardial Infarction: Detection by Cardiovascular Magnetic Resonance Using T1 Mapping Technique and Papillary Longitudinal Strain

The Role of Multimodality Imaging and 3D Printing in Ventricular Cone Constriction

Contact Info

Product

Resources

About