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Normal Values of the Mitral-Aortic Intervalvular Fibrosa Thickness: A Multimodality Study

Alberto Cresti1, Pasquale Baratta1, Francesco De Sensi1

  • 1Cardio-Neurovascular Department, Misricordia Hospital, Grosseto, Italy.

Journal of Cardiovascular Echography
|November 16, 2019
PubMed
Abstract

Insights

Normal mitral-aortic intervalvular fibrosa (MAIVF) thickness in healthy adults is under 0.600 cm. Increased MAIVF thickness may indicate early periaortic abscess formation from infective endocarditis, requiring prompt evaluation.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Infectious Diseases

Background:

  • The mitral-aortic intervalvular fibrosa (MAIVF) is a critical area prone to infective endocarditis (IE) complications like abscesses.
  • Early detection of MAIVF thickening is vital for timely intervention in IE cases.
  • Establishing normal MAIVF thickness reference values is essential for accurate diagnosis.

Purpose of the Study:

  • To define the normal reference ranges for MAIVF thickness using transesophageal echocardiography (TEE) in healthy adults.
  • To establish diagnostic criteria for identifying MAIVF abnormalities indicative of IE complications.

Main Methods:

  • Consecutive adult patients undergoing TEE were enrolled.
  • MAIVF thickness was measured in short-axis (SAX) and long-axis (LAX) views.
  • Statistical analysis included mean-2SD, confidence intervals, and ROC curves to determine optimal cutoff values.

Main Results:

  • Normal MAIVF thickness in SAX view was 0.325 cm and in LAX view was 0.340 cm (mean-2SD).
  • ROC analysis identified SAX cutoff of 0.552 cm (95.2% AUC) and LAX cutoff of 0.623 cm (93.3% AUC).
  • No significant correlation was found between MAIVF thickness, age, or sex.

Conclusions:

  • Normal MAIVF thickness in healthy individuals should not exceed 0.600 cm.
  • MAIVF thickness above this threshold warrants suspicion for periaortic abscess formation.
  • Increased MAIVF thickness is a potential early indicator of perivalvular IE requiring urgent specialist evaluation.
Keywords:
Abscessinfective endocarditismitral-aortic intervalvular fibrosapseudoaneurysm

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