Skip Navigation

European Journal of Echocardiography 2004 5(5):326-334; doi:10.1016/j.euje.2004.03.001
© 2004 by European Society of Cardiology
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Agricola, E.
Right arrow Articles by Alfieri, O.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Agricola, E.
Right arrow Articles by Alfieri, O.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Copyright © 2004, The European Society of Cardiology

Echocardiographic classification of chronic ischemic mitral regurgitation caused by restricted motion according to tethering pattern

Eustachio Agricolaa,*, Michele Oppizzia, Francesco Maisanob, Michele De Bonisb, Arend F.L. Schinkelc, Lucia Torraccab, Alberto Margonatoa, Giulio Melisurgoa and Ottavio Alfierib

aDivision of Non-Invasive Cardiology, Department of Cardiology, San Raffaele Hospital, Via Olgettina 60, 20132 Milano, Italy
bDivision of Cardiac Surgery, San Raffaele Hospital, IRCCS, Via Olgettina 60, 20132 Milano, Italy
cDepartment of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, Netherlands

Received 9 October 2003; received in revised form 30 January 2004; accepted after revision 2 March 2004.

* Corresponding author. Tel.: +39-02-26437313; fax: +39-02-26437358. agricola.eustachio{at}hsr.it


  Abstract

Although the mechanism of ischemic mitral regurgitation (MR) is understood, the echocardiographic picture of ischemic MR is not homogeneous. Ninety-two consecutive patients with chronic ischemic MR due to restricted motion were divided into two groups according to tethering pattern: the asymmetric group with predominant posterior tethering of both leaflets (54 patients) and the symmetric one with predominant apical tethering of both leaflets (38 patients). The mitral deformation indexes, LV global (volume, function and sphericity) and local (papillary muscle displacements and regional wall motion score index) remodeling were evaluated. All indexes of global LV remodeling were significantly higher in the symmetric than asymmetric group (all p<0.0001), such as the posterior and lateral displacement of the anterior papillary muscle (both p<0.04), the papillary muscle separation and the anterior papillary muscle wall motion index (both p<0.0001). The origin as well as the direction of the jet was central in all patients of the symmetric group. In the asymmetric one the origin was central in 78% of the cases and arising from the medial commissure in 22% whereas the jet direction was posterior and central in 83% and 17% of patients, respectively. Therefore, it is possible to distinguish at least two subgroups of patients with ischemic MR due to restricted motion on the basis of tethering pattern, different degree of local and global LV remodeling and characteristics of the regurgitant jet.

Keywords: Ischemic mitral regurgitation; Echocardiography; Remodeling


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
V. Mor-Avi, L. Sugeng, and R. M. Lang
Real-Time 3-Dimensional Echocardiography: An Integral Component of the Routine Echocardiographic Examination in Adult Patients?
Circulation, January 20, 2009; 119(2): 314 - 329.
[Full Text] [PDF]

Home page
 Eur J EchocardiogrHome page
T. A. Armen, R. Vandse, J. A. Crestanello, S. V. Raman, K. M. Bickle, and N. S. Nathan
Mechanisms of valve competency after mitral valve annuloplasty for ischaemic mitral regurgitation using the Geoform ring: insights from three-dimensional echocardiography
Eur J Echocardiogr, January 1, 2009; 10(1): 74 - 81.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Gelsomino, R. Lorusso, S. Caciolli, I. Capecchi, C. Rostagno, M. Chioccioli, G. De Cicco, G. Bille, P. Stefano, and G. F. Gensini
Insights on left ventricular and valvular mechanisms of recurrent ischemic mitral regurgitation after restrictive annuloplasty and coronary artery bypass grafting.
J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 507 - 518.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
C. Ypenburg, P. Lancellotti, L. F. Tops, E. Boersma, G. B. Bleeker, E. R. Holman, J. D. Thomas, M. J. Schalij, L. A. Pierard, and J. J. Bax
Mechanism of improvement in mitral regurgitation after cardiac resynchronization therapy
Eur. Heart J., March 2, 2008; 29(6): 757 - 765.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EchocardiogrHome page
E. Agricola, M. Oppizzi, M. Pisani, A. Meris, F. Maisano, and A. Margonato
Ischemic mitral regurgitation: mechanisms and echocardiographic classification
Eur J Echocardiogr, March 1, 2008; 9(2): 207 - 221.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
W. Bothe, T. C. Nguyen, D. B. Ennis, A. Itoh, C. J. Carlhall, D. T. Lai, N. B. Ingels, and D. C. Miller
Effects of acute ischemic mitral regurgitation on three-dimensional mitral leaflet edge geometry
Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 191 - 197.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
J. Magne, P. Pibarot, F. Dagenais, Z. Hachicha, J. G. Dumesnil, and M. Senechal
Preoperative Posterior Leaflet Angle Accurately Predicts Outcome After Restrictive Mitral Valve Annuloplasty for Ischemic Mitral Regurgitation
Circulation, February 13, 2007; 115(6): 782 - 791.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
E Agricola, M Oppizzi, M Galderisi, M Pisani, A Meris, C Pappone, and A Margonato
Role of regional mechanical dyssynchrony as a determinant of functional mitral regurgitation in patients with left ventricular systolic dysfunction
Heart, October 1, 2006; 92(10): 1390 - 1395.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
E. Messas, C. Yosefy, M. Chaput, J. L. Guerrero, S. Sullivan, P. Menasche, A. Carpentier, M. Desnos, A. A. Hagege, G. J. Vlahakes, et al.
Chordal Cutting Does Not Adversely Affect Left Ventricle Contractile Function
Circulation, July 4, 2006; 114(1_suppl): I-524 - I-528.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
E. Kuwahara, Y. Otsuji, Y. Iguro, T. Ueno, F. Zhu, N. Mizukami, K. Kubota, K. Nakashiki, T. Yuasa, B. Yu, et al.
Mechanism of Recurrent/Persistent Ischemic/Functional Mitral Regurgitation in the Chronic Phase After Surgical Annuloplasty: Importance of Augmented Posterior Leaflet Tethering
Circulation, July 4, 2006; 114(1_suppl): I-529 - I-534.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
E. Messas, A. Bel, M. C. Morichetti, C. Carrion, M. D. Handschumacher, S. Peyrard, J. T. Vilquin, M. Desnos, P. Bruneval, A. Carpentier, et al.
Autologous Myoblast Transplantation for Chronic Ischemic Mitral Regurgitation
J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2086 - 2093.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
R. De Simone, I. Wolf, S. Mottl-Link, R. Hoda, B. Mikhail, F.-U. Sack, H.-P. Meinzer, and S. Hagl
A clinical study of annular geometry and dynamics in patients with ischemic mitral regurgitation: new insights into asymmetrical ring annuloplasty
Eur. J. Cardiothorac. Surg., March 1, 2006; 29(3): 355 - 361.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
Is a good perioperative echocardiographic result predictive of durability in ischemic mitral valve repair?
J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 565 - 573.e2.


Home page
 CirculationHome page
F. Zhu, Y. Otsuji, G. Yotsumoto, T. Yuasa, T. Ueno, B. Yu, C. Koriyama, S. Hamasaki, S. Biro, A. Kisanuki, et al.
Mechanism of Persistent Ischemic Mitral Regurgitation After Annuloplasty: Importance of Augmented Posterior Mitral Leaflet Tethering
Circulation, August 30, 2005; 112(9_suppl): I-396 - I-401.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
R. A. Levine and E. Schwammenthal
Ischemic Mitral Regurgitation on the Threshold of a Solution: From Paradoxes to Unifying Concepts
Circulation, August 2, 2005; 112(5): 745 - 758.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.