Background: We investigated mitral valve annular geometry changes during the cardiac cycle in patients with severe mitral regurgitation (MR) who underwent cardiac computed tomography angiography (CCTA) prior to percutaneous mitral valve replacement or annuloplasty. Methods: Fifty-one patients with severe MR and high surgical risk (Carpentier classification: 3 type I, 16 type II, 16 type IIIa, 16 type IIIb) underwent multiphase electrocardiographically gated (0–90%) CCTA, using a second generation dual-source CT scanner, as pre-procedural planning. Twenty-one patients without MR served as controls. The mitral valve annulus was segmented every 10% step of the R-R interval, according to the D-shaped segmentation model, and differences among groups were analysed by t-test or ANOVA. Results: Mitral annular area and diameters were larger in MR patients compared to controls, particularly in type II. Mitral annular area varied in MR patients throughout the cardiac cycle (mean ± standard deviation of maximum and minimum area 15.6 ± 3.9 cm2versus 13.0 ± 3.5 cm2, respectively; p = 0.001), with greater difference between annular areas versus controls (2.59 ± 1.61 cm2 and 1.98 ± 0.6 cm2, p < 0.001). The largest dimension was found in systolic phases (20–40%) in most of MR patients (n = 27, 53%), independent of Carpentier type (I: n = 1, 33%; II: n = 10, 63%; IIIa: n = 8, 50%; IIIb: n = 8, 50%), and in protodiastolic phases (n = 14, 67%) for the control group. Conclusions: In severe MR, mitral annular area varied significantly throughout the cardiac cycle, with a tendency towards larger dimensions in systole.

Dynamic changes of mitral valve annulus geometry at preprocedural CT: relationship with functional classes of regurgitation / A. Palmisano, V. Nicoletti, C. Colantoni, C.B. Monti, L. Pannone, D. Vignale, F. Darvizeh, E. Agricola, S. Schaffino, F. De Cobelli, A. Esposito. - In: EUROPEAN RADIOLOGY EXPERIMENTAL. - ISSN 2509-9280. - 5:1(2021 Aug 13), pp. 34.1-34.12. [10.1186/s41747-021-00231-3]

Dynamic changes of mitral valve annulus geometry at preprocedural CT: relationship with functional classes of regurgitation

C.B. Monti
;
2021

Abstract

Background: We investigated mitral valve annular geometry changes during the cardiac cycle in patients with severe mitral regurgitation (MR) who underwent cardiac computed tomography angiography (CCTA) prior to percutaneous mitral valve replacement or annuloplasty. Methods: Fifty-one patients with severe MR and high surgical risk (Carpentier classification: 3 type I, 16 type II, 16 type IIIa, 16 type IIIb) underwent multiphase electrocardiographically gated (0–90%) CCTA, using a second generation dual-source CT scanner, as pre-procedural planning. Twenty-one patients without MR served as controls. The mitral valve annulus was segmented every 10% step of the R-R interval, according to the D-shaped segmentation model, and differences among groups were analysed by t-test or ANOVA. Results: Mitral annular area and diameters were larger in MR patients compared to controls, particularly in type II. Mitral annular area varied in MR patients throughout the cardiac cycle (mean ± standard deviation of maximum and minimum area 15.6 ± 3.9 cm2versus 13.0 ± 3.5 cm2, respectively; p = 0.001), with greater difference between annular areas versus controls (2.59 ± 1.61 cm2 and 1.98 ± 0.6 cm2, p < 0.001). The largest dimension was found in systolic phases (20–40%) in most of MR patients (n = 27, 53%), independent of Carpentier type (I: n = 1, 33%; II: n = 10, 63%; IIIa: n = 8, 50%; IIIb: n = 8, 50%), and in protodiastolic phases (n = 14, 67%) for the control group. Conclusions: In severe MR, mitral annular area varied significantly throughout the cardiac cycle, with a tendency towards larger dimensions in systole.
Computed tomography angiography; Heart valve prosthesis; Mitral valve; Mitral valve insufficiency; Planning techniques; Computed Tomography Angiography; Humans; Retrospective Studies; Tomography, X-Ray Computed; Mitral Valve; Mitral Valve Insufficiency
Settore MED/36 - Diagnostica per Immagini e Radioterapia
13-ago-2021
Article (author)
File in questo prodotto:
File Dimensione Formato  
s41747-021-00231-3.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 4.57 MB
Formato Adobe PDF
4.57 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/913091
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 4
social impact