Journal of Cardiovascular Imaging

  • 제19권2호
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  • Pages.69-75
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  • 2011
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  • 2586-7210(pISSN)
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  • 2586-7296(eISSN)
한국심초음파학회 (Korean Society of Echocardiography)
권호 표지
DOI QR코드

DOI QR Code

ROLE OF DYSSYNCHRONY ON FUNCTIONAL MITRAL REGURGITATION IN PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY: A COMPARISON STUDY WITH GEOMETRIC PARAMETERS OF MITRAL APPARATUS

  • Choi, Woong-Gil (Division of Cardiology, Department of Internal Medicine, Konkuk University College of Medicine) ;
  • Kim, Soo-Hyun (Division of Cardiology, Department of Internal Medicine, Konkuk University College of Medicine) ;
  • Park, Sang-Don (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Baek, Young-Soo (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Shin, Sung-Hee (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Woo, Sung-Ill (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Kim, Dae-Hyeok (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Park, Keum-Soo (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Lee, Woo-Hyung (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Kwan, Jun (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine)
  • 발행 : 2011.06.27
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Functional mitral regurgitation (FMR) occurs commonly in patients with dilated cardiomyopathy (DCM). This study was conducted to explore the role of left ventricular (LV) dyssynchrony in developing FMR in patients with DCM in comparison with geometric parameters of the mitral apparatus. Methods: Twenty patients without FMR and 33 patients with FMR [effective regurgitant orifice area (ERO) = $0.17{\pm}0.10 cm^2$] were enrolled. MR severity was estimated with ERO area. Dyssynchrony indices (DI) were measured using the standard deviations of time to peak myocardial systolic velocity between eight segments. Using real time 3D echocardiography, mitral valve tenting area (MVTa), anterior (APMD) and posterior papillary muscle distances (PPMD), LV sphericity, and tethering angle of anterior (A$\alpha$) and posterior leaflets (P$\alpha$) were estimated. All geometrical measurements were corrected (c) by the height of each patient. Results: The patient with FMR had significantly higher cDI, cMVTa, cAPMD and cPPMD, LV sphericity, A$\alpha$, and P$\alpha$ than the patients without FMR (all p < 0.05). With multiple logistic regression analysis, cMVTa (p = 0.017) found to be strongest predictor of FMR development. In patients with FMR, cMVTa (r = 0.868), cAPMD (r = 0.801), cPPMD (r = 0.742), A$\alpha$ (r = 0.454), LV sphericity (r = 0.452), and DI (r = 0.410) showed significant correlation with ERO. On multivariate regression analysis, cMVTa and cAPMD (p < 0.001, p = 0.022, respectively) remained the strongest determinants of the degree of ERO and cAPMD (p < 0.001) remained the strongest determinant of the degree of cMVTa. Conclusion: Displacement of anterior papillary muscle and consequent mitral valve tenting seem to play a major role in developing FMR in DCM, while LV dyssynchrony seems to have no significant role.

키워드

참고문헌

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피인용 문헌

  1. Three-dimensional echocardiography: a new paradigm shift vol.12, pp.1, 2014, https://doi.org/10.1007/s12574-013-0189-6
  2. Baseline QRS width and mitral regurgitation behavior after cardiac resynchronization therapy among patients with dilated cardiomyopathy vol.66, pp.4, 2011, https://doi.org/10.1016/j.ehj.2013.08.005