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Mitral regurgitation after cardiac transplantation
The American Journal of Cardiology
|July 1, 1987
Summary
Altered left atrial geometry after cardiac transplantation frequently causes mitral regurgitation. This suggests the left atrium is crucial for mitral valve function, even without intrinsic valve disease.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- The left atrium's role in mitral valve competence is not fully understood, particularly in conditions with altered atrial size and geometry.
- Cardiac transplantation provides a unique model to study the impact of left atrial changes on mitral valve function due to atrial anastomosis.
Purpose of the Study:
- To assess the contribution of the left atrium to mitral valve competence using a post-cardiac transplantation model.
- To investigate the relationship between abnormal left atrial geometry and the occurrence of mitral regurgitation.
Main Methods:
- Doppler and 2-dimensional echocardiography were performed on 16 patients after orthotopic cardiac transplantation.
- Measurements of left atrial size, geometry, mitral valve annular dimensions, and ventricular function were compared to 16 healthy controls.
Main Results:
- Mitral regurgitation was observed in 14 out of 16 transplanted patients.
- Transplanted left atria exhibited abnormal 'snowman' geometry and significant dilation compared to controls (23 +/- 6 vs 13 +/- 3 cm2, p < 0.001).
- Mitral valve annulus and ventricular function were normal, indicating regurgitation was linked to atrial abnormality.
Conclusions:
- Abnormal left atrial geometry, as seen after cardiac transplantation, can lead to mitral regurgitation independent of intrinsic mitral valve or left ventricular abnormalities.
- This study highlights the significant role of the left atrium in maintaining mitral valve competence, especially in conditions associated with left atrial enlargement.