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Mitral annular shape, size, and motion in normals and in patients with cardiomyopathy: evaluation with computed

Hatem Alkadhi1, Lotus Desbiolles, Paul Stolzmann

  • 1Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland. hatem.alkadhi@usz.ch

Investigative Radiology
|February 13, 2009
PubMed

Insights

Computed tomography (CT) reveals the mitral annulus (MA) is nonplanar and changes shape during the cardiac cycle. Patients with dilated cardiomyopathy (DCM) show significantly larger MA size and reduced motion compared to healthy individuals.

Area of Science:

  • Cardiovascular imaging
  • Cardiac morphology and function
  • Medical diagnostics

Background:

  • The mitral annulus (MA) is a dynamic structure crucial for cardiac function.
  • Understanding its three-dimensional (3D) shape, size, and motion is vital for diagnosing and managing heart conditions.
  • Previous studies have limited in vivo data on MA dynamics.

Purpose of the Study:

  • To prospectively evaluate the 3D shape, size, and motion of the mitral annulus (MA) in healthy subjects and patients with dilated cardiomyopathy (DCM) and hypertrophic obstructive cardiomyopathy (HOCM) using computed tomography (CT).

Main Methods:

  • Contrast-enhanced, ECG-gated 64-slice CT scans were performed on 20 healthy subjects, 15 DCM patients, and 15 HOCM patients.
  • Dedicated 3D software with a point-wrap algorithm was used for MA segmentation throughout the cardiac cycle.
  • MA shape, area, area change, apicobasal motion, and intercommissural distances were analyzed and compared between groups.

Main Results:

  • The MA was consistently nonplanar, larger in diastole, and smaller in systole across all subjects.
  • MA area was significantly larger in DCM patients (11.5 cm/m) compared to normals (5.5 cm/m) and HOCM (4.7 cm/m).
  • DCM patients exhibited significantly reduced MA area change (12.2%/m) and apicobasal motion (2.2 mm/m) compared to normals (20.0%/m, 3.6 mm/m) and HOCM (20.5%/m, 2.7 mm/m).

Conclusions:

  • This study provides novel in vivo human data on the 3D characteristics of the mitral annulus.
  • Significant alterations in MA size and motion were observed in patients with DCM.
  • The findings highlight potential CT-based biomarkers for assessing MA abnormalities in cardiomyopathies.
Abstract

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