Increased distance between mitral valve coaptation point and mitral annular plane: significance and correlations in

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S E Karagiannis1, G T Karatasakis, N Koutsogiannis

  • 1First Cardiology Department, Onassis Cardiac Surgery Centre, Athens, Greece. georgekar2001@yahoo.com

Heart (British Cardiac Society)
|September 17, 2003
PubMed

Insights

The distance between the mitral coaptation point and annulus (CPMA) correlates with left ventricular function. Interventions improving ejection fraction also reduced CPMA, indicating its dependence on cardiac contractility.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Mechanics

Background:

  • Failing left ventricles exhibit altered geometry and function.
  • Mitral regurgitation is common in heart failure, influenced by leaflet coaptation.
  • The coaptation point to annulus distance (CPMA) is a potential marker of ventricular remodeling.

Purpose of the Study:

  • To measure the mitral coaptation point to mitral annulus (CPMA) distance.
  • To assess the relationship between CPMA and left ventricular structural/functional characteristics in heart failure.
  • To evaluate CPMA changes during interventions aimed at improving cardiac function.

Main Methods:

  • Echocardiography was used to measure CPMA and other indices in 129 heart failure patients.
  • Correlations were assessed between CPMA and left ventricular dimensions, ejection fraction (LVEF), and mitral annulus dimensions.
  • CPMA and LVEF were measured at baseline and during dobutamine infusion or leg lifting (preload increase).

Main Results:

  • CPMA strongly correlated with left ventricular diastolic and systolic dimensions, LVEF, fractional shortening, E point septal separation, and mitral annulus dimension (all p < 0.001).
  • Dobutamine infusion and leg lifting reduced CPMA and increased LVEF, with changes being significantly related (r = 0.68 for dobutamine).
  • Interventions improved LVEF, fractional shortening, and diastolic dimensions, while decreasing CPMA and E point septal separation.

Conclusions:

  • The displacement of the mitral coaptation point towards the apex is multifactorial.
  • CPMA is significantly influenced by left ventricular function, as demonstrated by its inverse correlation with ejection fraction.
  • Changes in CPMA during interventions correlate with improvements in ejection fraction, highlighting its utility as a functional index.
Abstract

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