Mitral Annular Elasticity Determines Severity of Regurgitation in Barlow’s Mitral Valve Disease

Autor: Karl-Andreas, Dumont, Hans Martin, Dahl Aguilera, Robert, Persson, Victorien, Prot, John-Peder, Kvitting, Stig, Urheim
Rok vydání: 2022
Předmět:
Zdroj: Journal of the American Society of Echocardiography. 35:1037-1046
ISSN: 0894-7317
Popis: Barlow's mitral valve disease with late systolic mitral regurgitation provides diagnostic and therapeutic challenges. The mechanisms of the regurgitation are still unclear. We hypothesized that the onset and the severity of late systolic regurgitation are determined by annulus dynamics and the mechanical stresses imposed by the left ventricle.Ten patients with Barlow's mitral valve disease and mitral annulus disjunction (MAD) were compared with 10 healthy controls. Resting blood pressure was measured, and transthoracic three-dimensional echocardiography was analyzed using a holographic display that allows tracking and measurements of mitral annulus surface area (ASA) throughout the cardiac cycle. A novel annulus elastance index (dASA/dP) was calculated between aortic valve opening and onset of mitral regurgitation. Severity of MAD was quantified as the disjunction index (mm × degree). Leaflet coaptation area was calculated using a finite element model.Peak systolic ASAs in controls and patients were 9.3 ± 0.6 and 21.1 ± 3.1 cmThe present pilot study supports the hypothesis that annulus dilatation may accentuate mitral valve regurgitation in patients with Barlow's mitral valve disease. A novel annulus elastance index may predict the severity of mitral valve regurgitation in selected patients.
Databáze: OpenAIRE