Kwan Jun, Yeom Beom Woo, Jones Michael, Qin Jian Xin, Zetts Arthur D, Thomas James D, Shiota Takahiro
Department of Cardiology, Inha University Hospital, Jung-gu, Inchon, Korea.
J Korean Med Sci. 2006 Apr;21(2):217-23. doi: 10.3346/jkms.2006.21.2.217.
We performed real-time 3D echocardiography in sixteen sheep to compare acute geometric changes in the mitral annulus after left anterior descending coronary artery (LAD, n=8) ligation and those after left circumflex coronary artery (LCX, n=8) ligation. The mitral regurgitation (MR) was quantified by regurgitant volume (RV) using the proximal isovelocity surface area method. The mitral annulus was reconstructed through the hinge points of the annulus traced on 9 rotational apical planes (angle increment=20 degrees). Mitral annular area (MAA) and the ratio of antero-posterior (AP) to commissure-commissure (CC) dimension of the annulus were calculated. Non-planar angle (NPA) representing non-planarity of the annulus was measured. After LCX occlusion, there were significant increases of the MAA during both early and late systole (p<0.01) with significant MR (RV: 30+/-14 mL), while there was neither a significant increase of MAA, nor a significant MR (RV: 4+/-5 mL) after LAD occlusion. AP/CC ratio (p<0.01) and NPA (p<0.01) also significantly increased after LCX occlusion during both early and late systole. The mitral annulus was significantly enlarged in the antero-posterior direction with significant decrease of non-planarity compared to LAD occlusion immediately after LCX occlusion.
我们对16只绵羊进行了实时三维超声心动图检查，以比较左前降支冠状动脉（LAD，n = 8）结扎后和左旋支冠状动脉（LCX，n = 8）结扎后二尖瓣环的急性几何变化。采用近端等速表面积法通过反流容积（RV）对二尖瓣反流（MR）进行定量分析。通过在9个旋转心尖平面（角度增量 = 20度）上追踪二尖瓣环的铰链点来重建二尖瓣环。计算二尖瓣环面积（MAA）以及二尖瓣环前后径（AP）与瓣环连合间径（CC）的比值。测量代表二尖瓣环非平面性的非平面角（NPA）。在结扎LCX后，收缩早期和晚期的MAA均显著增加（p < 0.01），伴有显著的MR（RV：30±14 mL），而在结扎LAD后，MAA既无显著增加，也无显著的MR（RV：4±5 mL）。在结扎LCX后的收缩早期和晚期，AP/CC比值（p < 0.01）和NPA（p < 0.01）也显著增加。与结扎LAD后相比，结扎LCX后立即观察到二尖瓣环在前后方向上显著扩大，非平面性显著降低。
