Rottländer Dennis, Saal Martin, Ögütcü Alev, Degen Hubertus, Haude Michael
Department of Cardiology, Rheinlandklinikum Neuss, Neuss, Germany.
Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, Witten, Germany.
Front Cardiovasc Med. 2022 Apr 22;9:868562. doi: 10.3389/fcvm.2022.868562. eCollection 2022.
We aimed to investigate the anatomical relationship of the coronary sinus (CS) and the mitral valve annulus (MVA) in patients with or without functional mitral regurgitation (FMR) using a multislice CT (MSCT) software to determine (a) the distance and angle of both CS and MVA plane and (b) the mitral annulus geometry.
A total of 215 patients with MSCT and CS to MVA topography evaluation were enrolled in this retrospective study.
This patient cohort included 145 patients without FMR (67.4%, FMR ≤ 1+) and 70 patients (32.6%) with clinically relevant FMR (FMR ≥ 2+). Distance and angulation of CS to MVA planes were highly variable. In all groups, no significant correlation was documented between the distance or angle of CS to MVA planes and left ventricular ejection fraction, left ventricular end-diastolic diameter, or left atrial volume. A significant increase in total CS length could be found in patients with FMR ≥ 2+ compared to the FMR ≤ 1+ group. MVA diameter, area, and perimeter were significantly increased in FMR ≥ 2+ compared to FMR ≤ 1+. In the FMR ≥ 2+ cohort 61% showed a distance of CS to MVA plane <7.8 mm and 58% revealed an angle of CS to MVA plane <14.2°.
Distance and angulation of CS to MVA topography using an MSCT approach are similar between patients with or without FMR, while CS length, MVA area, MVA perimeter, anterior-posterior diameter, and intercommissural diameter are significantly increased in all FMR subgroups. However, ~60% of FMR ≥ 2+ patients showed favorable CS to MVA topography for indirect mitral annuloplasty.
我们旨在利用多层螺旋CT（MSCT）软件研究有或没有功能性二尖瓣反流（FMR）的患者中冠状窦（CS）与二尖瓣环（MVA）的解剖关系，以确定：（a）CS和MVA平面的距离和角度；（b）二尖瓣环的几何形状。
本回顾性研究共纳入215例接受MSCT及CS至MVA局部解剖评估的患者。
该患者队列包括145例无FMR的患者（67.4%，FMR≤1+）和70例（32.6%）有临床相关FMR的患者（FMR≥2+）。CS至MVA平面的距离和角度变化很大。在所有组中，CS至MVA平面的距离或角度与左心室射血分数、左心室舒张末期直径或左心房容积之间均未发现显著相关性。与FMR≤1+组相比，FMR≥2+的患者CS总长度显著增加。与FMR≤1+相比，FMR≥2+时MVA直径、面积和周长显著增加。在FMR≥2+队列中，61%的患者CS至MVA平面的距离<7.8 mm，58%的患者CS至MVA平面的角度<14.2°。
采用MSCT方法时，有或没有FMR的患者CS至MVA局部解剖的距离和角度相似，而在所有FMR亚组中，CS长度、MVA面积、MVA周长、前后径和瓣环间径均显著增加。然而，约60%的FMR≥2+患者显示CS至MVA局部解剖情况利于间接二尖瓣环成形术。
