Author + information
- Kitae Kim,
- Shuichiro Kaji,
- Yoshimori An,
- Tomohiro Nishino,
- Takeshi Kitai,
- Atsushi Kobori,
- Natsuhiko Ehara,
- Makoto Kinoshita,
- Tomoko Tani and
- Yutaka Furukawa
The mechanism that contributes to improvement of functional mitral regurgitation (FMR) by shortening of interpapillary muscle distance (IPMD) is not well investigated.
We analyzed volumetric MSCT images of mitral apparatus in 83 patients with LV dysfunction (EF<50%): 37 patients had significant FMR and remaining 46 patients did not have significant FMR. We also analyzed 20 control patients with normal LV function and without mitral regurgitation. Using the original software, we assessed 3D geometry of mitral apparatus including IPMD, tethering distances of both anterior and posterior papillary muscles (PMs), and mitral tenting volume at end–systole. Severity of FMR was assessed with vena contracta (VC) width by 2D echocardiography.
Posterior and anterior tethering distance, IPMD were significantly increased in patients with FMR than those without FMR and control patients. Patients with IPMD in the highest tertile had a significantly higher degrees of MR (mean±SE, 4.5±0.3 mm) compared with those in lowest and the second tertiles adjusting for PM tethering distance (mean±SE, 3.0±0.4 and 2.9±0.3 mm, p<0.001, respectively). Multivariate analysis showed that anteroposterior annular diameter and IPMD were the strongest determinants of FMR severity and mitral tenting volume.
IPMD, which affects leaflet tethering independently of PM tethering distance, was the major determinant of mitral tenting volume and FMR severity in patients with LV dysfunction.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Valvular Heart Disease: Clinical II – Mitral Valve
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1112M–82
- 2013 American College of Cardiology Foundation