Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation
Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation
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DOI：
10.1161/01.cir.0000053558.55471.2d
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发表时间：
2003-03-04
期刊：
影响因子：
37.8
通讯作者：
Thomas, JD
中科院分区：
文献类型：
--
作者：
Kwan, J;Shiota, T;Thomas, JD
背景-本研究旨在通过实时 3D 超声心动图 (RT3DE) 阐明缺血性心肌病 (ICM-MR) 和特发性扩张型心肌病 (DCM-MR) 引起的显着二尖瓣反流患者的二尖瓣装置的几何差异。方法和结果-26 名后壁梗塞引起的 ICM-MR 患者、18 名 DCM-MR 患者和 18 名 DCM-MR 患者。对 8 名对照受试者进行了研究。使用 3D 软件，生成连合平面和 3 个垂直的前后 (AP) 平面，用于对收缩中期二尖瓣 (MV) 的内侧、中央和外侧进行成像。在 3 个 AP 平面中，测量环形平面和每个小叶（前叶，Aalpha；后叶，Palpha）之间的角度。在ICM-MR中，内侧和中央平面测量的Aa显着大于外侧平面（分别为39+/-5度、34+/-6度和27+/-5度；P<0。05）。在DCM-MR中，Aalpha（38+/-8度、37+/-9度和36+/-7度，P>0.05）和Pa（59+/-6度、58+/-5度和57+/-6度，P>0.05）在3个平面上均未发现显着差异。 结论：ICM-MR中MV从内侧到外侧的变形模式是不对称的，而DCM-MR 中对称。 RT3DE 是区分这两种不同类型的功能性二尖瓣反流的二尖瓣装置几何形状的有用工具。
Background-This study was conducted to elucidate the geometric differences of the mitral apparatus in patients with significant mitral regurgitation caused by ischemic cardiomyopathy (ICM-MR) and by idiopathic dilated cardiomyopathy (DCM-MR) by use of real-time 3D echocardiography (RT3DE).Methods and Results-Twenty-six patients with ICM-MR caused by posterior infarction, 18 patients with DCM-MR, and 8 control subjects were studied. With the 3D software, commissure-commissure plane and 3 perpendicular anteroposterior (AP) planes were generated for imaging the medial, central, and lateral sides of the mitral valve (MV) during mid systole. In 3 AP planes, the angles between the annular plane and each leaflet (anterior, Aalpha; posterior, Palpha) were measured. In ICM-MR, Aa measured in the medial and central planes was significantly larger than that in the lateral plane (39+/-5degrees, 34+/-6degrees, and 27+/-5degrees, respectively; P0.05). In DCM-MR, both Aalpha (38+/-8degrees, 37+/-9degrees, and 36+/-7degrees, P>0.05) and Pa (59+/-6degrees, 58+/-5degrees, and 57+/-6degrees, P>0.05) revealed no significant differences in the 3 planes.Conclusions-The pattern of MV deformation from the medial to the lateral side was asymmetrical in ICM-MR, whereas it was symmetrical in DCM-MR. RT3DE is a helpful tool for differentiating the geometry of the mitral apparatus between these 2 different types of functional mitral regurgitation.