Division of Cardiology, Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, PA, USA.
Arq Bras Cardiol. 2013 Jun;100(6):571-8. doi: 10.5935/abc.20130103. Epub 2013 May 14.
Mitral regurgitation is the most common valvular heart disease worldwide. Magnetic resonance may be a useful tool to analyze mitral valve parameters.
To distinguish mitral valve geometric patterns in patients with different severities of mitral regurgitation (MR) based on cardiovascular magnetic resonance imaging.
Sixty-three patients underwent cardiovascular magnetic resonance imaging. Mitral valve parameters analyzed were: tenting area (mm2) and angle (degrees), ventricle height (mm), tenting height (mm), anterior leaflet, posterior leaflet length and annulus diameter (mm). Patients were divided into two groups, one including patients who required mitral valve surgery and another which did not.
Thirty-six patients had trace to mild (1-2+) MR and 27 had moderate to severe MR (3-4+). Ten (15.9%) out of 63 patients underwent surgery. Patients with more severe MR had a larger left ventricle end systolic diameter (38.6 ± 10.2 vs 45.4 ± 16.8, p<0.05) and left end diastolic diameter (52.9 ± 6.8 vs 60.1 ± 12.3, p= 0.005). On multivariate analysis, the tenting area was the strongest determinant of MR severity (r= 0.62, p=0.035). Annulus length (36.1 ± 4.7 vs 41 ± 6.7, p< 0.001), tenting area (190.7 ± 149.7 vs 130 ± 71.3, p= 0.048) and posterior leaflet length (15.1 ± 4.1 vs 12.2 ± 3.5, p= 0.023) were larger on patients requiring mitral valve surgery.
Tenting area, annulus and posterior leaflet length are possible determinants of MR severity. These geometric parameters could be used to determine severity and could, in the future, direct specific patient care based on individual mitral apparatus anatomy.
二尖瓣反流是全球最常见的瓣膜性心脏病。磁共振检查可能是一种用于分析二尖瓣参数的有用工具。
基于心血管磁共振成像，区分不同严重程度二尖瓣反流（MR）患者的二尖瓣几何形态。
63 例患者行心血管磁共振成像检查。分析的二尖瓣参数包括：瓣叶膨出面积（mm²）和角度（度）、心室高度（mm）、瓣叶膨出高度（mm）、前叶、后叶长度和瓣环直径（mm）。患者分为两组，一组包括需要二尖瓣手术的患者，另一组则不需要。
36 例患者为微量至轻度（1-2+）MR，27 例为中重度 MR（3-4+）。63 例患者中，10 例（15.9%）接受了手术。MR 更严重的患者左心室收缩末期直径更大（38.6±10.2 比 45.4±16.8，p<0.05）和左心室舒张末期直径更大（52.9±6.8 比 60.1±12.3，p=0.005）。多变量分析显示，瓣叶膨出面积是 MR 严重程度的最强决定因素（r=0.62，p=0.035）。瓣环长度（36.1±4.7 比 41±6.7，p<0.001）、瓣叶膨出面积（190.7±149.7 比 130±71.3，p=0.048）和后叶长度（15.1±4.1 比 12.2±3.5，p=0.023）在需要二尖瓣手术的患者中更大。
瓣叶膨出面积、瓣环和后叶长度可能是 MR 严重程度的决定因素。这些几何参数可用于确定严重程度，并可能在未来根据个体二尖瓣装置解剖结构指导特定的患者护理。
