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Valve Strain Quantitation in Normal Mitral Valves and Mitral Prolapse With Variable Degrees of Regurgitation

Authors :
K. Carlos El-Tallawi
Mohammed A. Chamsi-Pasha
Jiaqiong Xu
Peng Zhang
Robert Azencott
Elizabeth Herrera
Gerald M. Lawrie
Jiwen He
William A. Zoghbi
Jessen Jacob
Source :
JACC. Cardiovascular imaging. 14(6)
Publication Year :
2020

Abstract

Objectives The aim of this study was to quantitate patient-specific mitral valve (MV) strain in normal valves and in patients with mitral valve prolapse with and without significant mitral regurgitation (MR) and assess the determinants of MV strain. Background Few data exist on MV deformation during systole in humans. Three-dimensional echocardiography allows for dynamic MV imaging, enabling digital modeling of MV function in health and disease. Methods Three-dimensional transesophageal echocardiography was performed in 82 patients, 32 with normal MV and 50 with mitral valve prolapse (MVP): 12 with mild mitral regurgitation or less (MVP − MR) and 38 with moderate MR or greater (MVP + MR). Three-dimensional MV models were generated, and the peak systolic strain of MV leaflets was computed on proprietary software. Results Left ventricular ejection fraction was normal in all groups. MV annular dimensions were largest in MVP + MR (annular area: 13.8 ± 0.7 cm2) and comparable in MVP − MR (10.6 ± 1 cm2) and normal valves (10.5 ± 0.3 cm2; analysis of variance: p Conclusions MVs that exhibit prolapse have higher strain compared to normal valves, particularly in the posterior leaflet. Although higher strain is observed with worsening MR and larger valves and annuli, mitral valve leaflet thickness—and, thus, underlying MV pathology—is the most significant independent determinant of valve deformation. Future studies are needed to assess the impact of MV strain determination on clinical outcome.

Details

ISSN :
18767591
Volume :
14
Issue :
6
Database :
OpenAIRE
Journal :
JACC. Cardiovascular imaging
Accession number :
edsair.doi.dedup.....db85a86f5672c6bd0c570b85514665ad