Related Experiment Video
Updated: May 18, 2026
07:11
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Three-dimensional echocardiographic analysis of mitral annular dynamics: implication for annuloplasty selection
Melissa M Levack1, Arminder S Jassar, Eric K Shang
1Gorman Cardiovascular Research Group, Glenolden, PA 19036, USA.
Circulation
|September 12, 2012
Summary
Mitral annular dynamics are impaired in patients with ischemic and myxomatous mitral regurgitation. This suggests flexible annuloplasty rings may not restore normal annular function during mitral valve repair.
Area of Science:
- Cardiovascular research
- Cardiac surgery
- Echocardiography
Background:
- Flexible annuloplasty rings aim to preserve mitral annular dynamics.
- This assumes normal annular motion in patients undergoing mitral valve repair.
- This study investigates mitral annular dynamics in specific mitral regurgitation types.
Purpose of the Study:
- To test the hypothesis that mitral annular dynamics are impaired in ischemic and myxomatous mitral regurgitation.
- To evaluate the impact of these conditions on mitral annulus anatomy and motion.
Main Methods:
- Real-time 3D transesophageal echocardiography was used in 11 normal subjects, 11 with ischemic mitral regurgitation, and 11 with myxomatous mitral regurgitation.
- Image analysis involved semiautomated annular tracking to assess dynamics.
- Parameters were normalized for uniform systolic and diastolic periods.
Main Results:
- Both ischemic and myxomatous mitral regurgitation annuli were significantly larger in midsystolic area compared to normal annuli.
- Ischemic mitral regurgitation annuli demonstrated reduced dynamics compared to controls.
- Myxomatous mitral regurgitation annuli showed abnormal dilation in early systole.
Conclusions:
- Mitral annular dynamics and anatomy are abnormal in both ischemic and myxomatous mitral regurgitation.
- Flexible annuloplasty devices are unlikely to restore normal annular dynamics or anatomy in these conditions.
Related Concept Videos
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
01:22Mitral Valve Prolapse II: Assessment and Management
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:27Mitral Valve Prolapse I: Introduction
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...