Multimodality imaging assessment of mitral valve anatomy in planning for mitral valve repair in secondary mitral regurgitation

Capoulade, Romain; Meneveau, Nicolas; Serfaty, Jean-Michel; Tourneau, Thierry Le

doi:10.21037/jtd.2017.06.99

Cited by 16 publications

(5 citation statements)

References 187 publications

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“…The MR jet is central in patients with global wall motion abnormalities, with equal lateral displacement of the PMs, similar to nonischemic cardiomyopathy 21 (Figure 3 might occur in patients with multiple vessel disease and old inferior MI, mainly affecting the posterior PM. 21 The jet is posterior in patients with dominant posterior leaflet tethering 22 (Figure 3(c), (d)). MA enlargement and flattening with increased leaflet stress is another factor contributing to the development of FMR.…”

Section: Complex Anatomy Of the MVmentioning

confidence: 98%

Echocardiographic quantification of mitral apparatus morphology and dynamics in patients with dilated cardiomyopathy

Toader

2024

J Int Med Res

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Mitral regurgitation is among the most common valvular heart diseases. Mitral regurgitation in patients with dilated cardiomyopathy is a complex pathology involving annular dilatation, papillary muscle displacement, systolic leaflet tethering, and left ventricular remodeling. Quantification of mitral apparatus damage in these patients is essential for successful interventional and surgical therapy. Mitral regurgitation in the presence of dilated cardiomyopathy is classified as Carpentier type IIIB, with restricted leaflet mobility as a standard feature. Echocardiography allows accurate evaluation of the complex anatomy and function of the mitral apparatus. Updated guidelines recommend two-dimensional followed by systematic three-dimensional echocardiographic evaluation in patients with mitral regurgitation. New three-dimensional echocardiographic software packages provide many parameters that help identify the precise morphology and function of the various components of the mitral apparatus, helping to determine the etiology of mitral regurgitation and evaluate disease severity. This review provides the first point-by-point approach to the assessment of all old and new echocardiographic methods, from the simplest to the most complex, used to examine the components of the mitral valve apparatus in patients with dilated cardiomyopathy. Although these parameters are still under research, this information will be helpful for establishing therapeutic procedures in a disease with a poor prognosis.

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Section: Complex Anatomy Of the MVmentioning

confidence: 98%

Echocardiographic quantification of mitral apparatus morphology and dynamics in patients with dilated cardiomyopathy

Toader

2024

J Int Med Res

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“…Regarding MR, as mentioned, echocardiography is crucial in determining etiology, morphology, and mechanism, especially in secondary or functional origin cases. Therefore, many echocardiographic methods should be considered to quantify MR [27,[49][50][51][52], as reported in Table 2. The 2020 American College of Cardiology/American Heart Association Guidelines report that threshold criteria for functional MR should now be similar to that for primary MR, i.e., effective regurgitant orifice area (EROA) ≥ 0.4 cm 2 , regurgitant volume (RVol) ≥ 60 mL, and a regurgitant fraction (RF) ≥ 50% [53].…”

Section: Resting Echocardiographymentioning

confidence: 99%

“…In addition, it helps understand the etiology of the underlying pathological process, especially in secondary MR. Moreover, CMR provides better spatial resolution, which aids in the detailed characterization of MV morphology and subvalvular apparatus [49]. It also quantifies MV RVol (MRV) using direct methods based on the velocity-encoded sequences and indirect quantifications based on the various SV calculations using the volumetric method or PC imaging [106].…”

Section: Cmr Is the Most Useful Imaging Technique For Differentiating...mentioning

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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“…The MV tenting area and tethering pattern reflect the severity of adverse MV apparatus remodeling and the extent of papillary muscle displacement. An increased MV tenting area represents apical tethering of the MV leaflets and movement of the coaptation point away from the annulus [26]. These alterations increase in severity with more global or extensive LV remodeling, such as after a large anterior wall MI or severe multivessel coronary artery disease [3,27].…”

Section: Commentmentioning

confidence: 99%

Risk of Ischemic Mitral Regurgitation Recurrence After Combined Valvular and Subvalvular Repair

Nappi

Lusini

Singh

et al. 2019

The Annals of Thoracic Surgery

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Background. Mitral valve repair (MVr) combined with papillary muscle approximation (PMA) may improve repair durability in severe ischemic mitral regurgitation (MR), when compared with MVr alone. We sought to identify preoperative transthoracic echocardiographic markers associated with MR recurrence after MVr with PMA. Methods. A post-hoc analysis was performed on patients with severe ischemic MR who underwent coronary artery bypass graft surgery with MVr with PMA in the papillary muscle approximation randomized trial. The PMA was performed utilizing a 4-mm polytetrafluoroethylene graft placed around the papillary muscles. Linear regression analyses and receiver-operating characteristic curves were used to identify echocardiographic variables and diagnostic models associated with recurrent MR. Results. There were 48 patients with a mean age of 63 ± 7 years, a left ventricular ejection fraction of 35% ± 5%, and a left ventricular end-diastolic diameter of 63 ± 3 mm. Of these, 37 patients had baseline and 5-year follow-up echocardiograms, with moderate-to-severe MR recurring

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Multimodality imaging assessment of mitral valve anatomy in planning for mitral valve repair in secondary mitral regurgitation

Cited by 16 publications

References 187 publications

Echocardiographic quantification of mitral apparatus morphology and dynamics in patients with dilated cardiomyopathy

Echocardiographic quantification of mitral apparatus morphology and dynamics in patients with dilated cardiomyopathy

Mitral and Tricuspid Valve Disease in Athletes

Risk of Ischemic Mitral Regurgitation Recurrence After Combined Valvular and Subvalvular Repair

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