Related Experiment Video

Updated: Jun 18, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

Relationship Between Position, Shape, and Deformation of Papillary Muscles and Mitral Regurgitation After

Xi Li1,2, Fei Chen1,2, Wenxia Zhou1

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 17, 2026
PubMed
Abstract

Insights

Papillary muscle (PM) displacement, particularly inferior displacement, is linked to poor mitral regurgitation (MR) outcomes after transcatheter aortic valve replacement (TAVR). Understanding PM attachment range can predict MR improvement post-TAVR.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Moderate/severe mitral regurgitation (MR) impacts transcatheter aortic valve replacement (TAVR) prognosis.
  • The role of papillary muscles (PMs) in TAVR outcomes, specifically MR, is under-investigated.

Purpose of the Study:

  • To investigate the association between papillary muscle (PM) characteristics and mitral regurgitation (MR) improvement following transcatheter aortic valve replacement (TAVR).

Main Methods:

  • Retrospective cohort study of 1159 TAVR patients; 125 with MR ≥3+ were analyzed.
  • Papillary muscle (PM) morphology and attachment were assessed using multi-slice computed tomography (MSCT).
  • Two-dimensional speckle tracking analyzed PM attachment deformation and synchrony.

Main Results:

  • No significant differences in PM morphology or myocardial deformation/synchrony were found between improved MR (IMR) and non-improved MR (NMR) groups.
  • Increased PM attachment range was observed in the NMR group compared to the IMR group.
  • Inferior displacement of PMs independently predicted less MR improvement after TAVR (OR: 5.629).

Conclusions:

  • Papillary muscles (PMs) in patients with unalleviated MR post-TAVR showed increased apical attachment range.
  • Inferior displacement of PMs is an independent risk factor for persistent moderate/severe MR after TAVR.
Keywords:
echocardiographymitral regurgitationmulti‐slice computed tomographypapillary musclestranscatheter aortic valve replacement

More Related Videos

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement09:57

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement

Published on: January 20, 2022

Related Concept Videos

Mitral Valve Prolapse I: Introduction01:27

Mitral 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...
Mitral Regurgitation I: Introduction01:20

Mitral 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...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Mitral Regurgitation III: Medical Management01:25

Mitral 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...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral 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.
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...