Mitral annular dilatation and papillary muscle dislocation without mitral regurgitation in sheep.
Mitral annular dilatation and papillary muscle dislocation without mitral regurgitation in sheep.
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绵羊二尖瓣环扩张和乳头肌脱位，无二尖瓣反流。
DOI：
10.1161/01.cir.100.suppl_2.ii-95
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发表时间：
1999
期刊：
影响因子：
37.8
通讯作者：
Miller,DC
中科院分区：
文献类型：
--
作者：
Green,GR;Dagum,P;Glasson,JR;Daughters,GT;Bolger,AF;Foppiano,LE;Berry,GJ;IngelsJr,NB;Miller,DC
背景-不对称二尖瓣环（MA）扩张和乳头肌脱位与功能性二尖瓣返流（MR）的发病机制有关。方法和结果-为了确定二尖瓣环和乳头肌几何结构改变导致MR的机制，我们在2组绵羊的左心室、二尖瓣环、二尖瓣前叶和后叶以及乳头肌尖端和基部植入了不透射线标记物。一组作为对照组（CTL，n=7）;实验组（EXP，n=9）接受局部苯酚应用以闭塞前瓣环和瓣叶肌肉（经组织学离体证实）。恢复1周后，使用双平面视频荧光透视对标记进行成像，并记录血流动力学数据。EXP组的MA面积（根据三维标记坐标计算）比CTL组大11%至13%（ANOVA，P<0.05）。该面积增加完全由连合间轴增加引起，除了1个心脏的连合间和隔外侧环轴均大幅增加（>1 cm）。收缩末期，EXP中的前乳头肌尖端向左心室前外侧移位2.9±0.23 mm，向二尖瓣环移位2.5±0.12 mm;后乳头肌几何形状不变。经胸超声心动图显示MR只在心脏表现出双轴annulationandconclusions-MA扩张在连合间的尺寸与前乳头肌尖端位移向环是不足以产生MR羊。功能性二尖瓣返流可能需要隔外侧轴的MA扩张，如近端回旋支冠状动脉闭塞所观察到的。
Background—Asymmetrical mitral annular (MA) dilatation and papillary muscle dislocation are implicated in the pathogenesis of functional mitral regurgitation (MR).Methods and Results—To determine the mechanism by which annular and papillary muscle geometric alterations result in MR, we implanted radiopaque markers in the left ventricle, mitral annulus, anterior and posterior mitral leaflets, and papillary muscle tips and bases in 2 groups of sheep. One group served as controls (CTL, n=7); an experimental group (EXP, n=9) underwent topical phenol application to obliterate anterior annular and leaflet muscle (confirmed histologically ex vivo). After 1 week of recovery, markers were imaged with biplane videofluoroscopy, and hemodynamic data were recorded. MA area (computed from 3-dimensional marker coordinates) was 11% to 13% larger in the EXP group than in the CTL group (P<0.05 by ANOVA). This area increase resulted exclusively from intercommissural axis increase except in 1 heart with large (>1 cm) increases in both the intercommissural and septolateral annular axes. The anterior papillary muscle tip in EXP was displaced from CTL by 2.9±0.23 mm toward the anterolateral left ventricle and 2.5±0.12 mm toward the mitral annulus at end systole; the posterior papillary muscle geometry was unchanged. Transthoracic echocardiography revealed MR only in the heart exhibiting biaxial annular enlargement.Conclusions—MA dilatation in the intercommissural dimension with anterior papillary muscle tip displacement toward the annulus is insufficient to produce MR in sheep. Functional MR may require MA dilatation in the septolateral axis, as observed with proximal circumflex coronary occlusion.
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影响因子：
37.8
作者：
Shengqiu He;Arnold A. Fontaine;E. Schwammenthal;Ajit P. Yoganathan;Robert A. Levine
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作者：
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DOI：
10.1016/0003-4975(93)90402-4
发表时间：
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期刊：
The Annals of thoracic surgery
影响因子：
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作者：
Moon,MR;Castro,LJ;DeAnda,A;Tomizawa,Y;Daughters2nd,GT;IngelsJr,NB;Miller,DC
通讯作者：
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影响因子：
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作者：
Kaul,S;Pearlman,JD;Touchstone,DA;Esquival,L
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