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Thorac Cardiovasc Surg 2006; 54(7): 452-458
DOI: 10.1055/s-2006-924435
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Three-Dimensional Assessment of Left Ventricular Geometry and Annular Dilatation Provides New Mechanistic Insights into the Surgical Correction of Ischemic Mitral Regurgitation[1]

R. De Simone1 , I. Wolf2 , R. Hoda1 , B. Mikhail1 , S. Mottl-Link1 , H.-P. Meinzer2 , S. Hagl1
  • 1Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
  • 2Department of Medicine and Biology Informatics, DKFZ (German Cancer Research Centre), Heidelberg, Germany
Further Information

Publication History

Received February 17, 2006

Publication Date:
06 November 2006 (online)

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Abstract

Background: The aim of this study was to investigate the relationship between LV geometry, annular shape and the amount of regurgitation in patients with ischemic mitral regurgitation (group 1, n = 30) compared to patients with primary mitral valve lesions (group 2, n = 30). Methods: LV geometry was assessed by the sphericity index, i.e., LV volume divided by the volume of a sphere with a diameter equal to the longest axis. Annular geometry was evaluated by diameters, areas and their percentual shortening. The degree of mitral regurgitation was assessed as jet volumes by 3D‐echocardiography. Results: Group 1 showed significantly larger longitudinal (54.3 ± 3.1 vs. 40.9 ± 2.6 mm) and antero-posterior (32.2 ± 3.3 vs. 27.1 ± 2.9 mm) annulus diameters and areas (993.3 ± 66.6 vs. 702.1 ± 47.9 mm2) than group 2. No asymmetric annular enlargement was found in either group. Annular enlargement correlated to the degree of mitral regurgitation in group 1 but not in group 2. Annular area shortening was significantly impaired in group 2 and the sphericity index was larger in group 1 than in group 2. In group 1, the sphericity index was significantly correlated to the degree of mitral regurgitation (r = 0.87; p < 0.001). Conclusions: These findings suggest that ischemic mitral regurgitation was mostly associated with a global left ventricular enlargement, in which annulus dilatation and its reduced contraction play a significant role.

Key words

Coronary artery disease - ischemic mitral regurgitation - annuloplasty - three-dimensional echocardiography - cardiac surgery - left ventricular geometry

1 Presented at the 35th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery in Hamburg, Germany, February 19 - 22, 2006

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1 Presented at the 35th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery in Hamburg, Germany, February 19 - 22, 2006

PD Dr. med. Raffaele De Simone

Department of Cardiac Surgery
University of Heidelberg

Im Neuenheimer Feld 110

69120 Heidelberg

Germany

Phone: + 49 62 21 56 63 95

Fax: + 49 62 21 56 55 85

Email: r.de.simone@urz.uni-heidelberg.de