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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
Summary
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.
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