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Regional geometric differences between regurgitant and non-regurgitant mitral valves in patients with coronary artery

Aidan Sharkey1, Feroze Mahmood1, Ting Hai2

  • 1Department of Anesthesia Critical Care and Pain Management, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Echocardiography (Mount Kisco, N.Y.)
|April 1, 2023
PubMed

Insights

Regional differences in mitral valve (MV) geometry exist in patients with coronary artery disease (CAD). Even without mitral regurgitation (MR), MV reserve varies, indicating potential for future issues.

Area of Science:

  • Cardiovascular Imaging
  • Cardiac Surgery
  • Echocardiography

Background:

  • Coronary artery disease (CAD) can cause heterogeneous ischemic remodeling.
  • This remodeling affects mitral valve (MV) geometry and function.
  • Understanding these changes is crucial for assessing mitral regurgitation (MR) risk.

Purpose of the Study:

  • To investigate regional geometric differences between regurgitant and non-regurgitant MVs in CAD patients.
  • To assess the anatomical reserve and likelihood of developing MR in non-regurgitant MVs within CAD patients.

Main Methods:

  • Retrospective analysis of intraoperative 3D transesophageal echocardiographic data.
  • Comparison of regional MV geometry and MV reserve between patients with (IMR) and without (NMR) MR.
  • Calculation of MV reserve in three distinct MV zones.

Main Results:

  • Significant regional geometric differences were observed between IMR and NMR groups.
  • NMR group had greater coaptation length and MV reserve in zones 1 and 2 compared to the IMR group.
  • Depletion of MV reserve correlated with posterior displacement of the coaptation point.

Conclusions:

  • Significant regional geometric disparities exist between regurgitant and non-regurgitant MVs in CAD.
  • Absence of MR does not equate to normal MV function due to regional variations in anatomical reserve.
  • Assessing MV reserve is vital for predicting MR risk in CAD patients.
Abstract

Keywords:
anatomical coaptation reservecoronary artery diseaseischemiamitral regurgitationmitral valve

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