RT 3D TEE: Characteristics of Mitral Valve in Ischemic Mitral Regurgitation Evaluated by MVQ Program

Aim: To assess the changes of mitral valve (MV) in ischemic mitral regurgitation (IMR) using Mitral Valve Quantification (MVQ) program. Methods: We examined 46 patients (18 women) with IMR aged 45-86 and a control group of 33 healthy individuals (14 women) aged 18-88. Following parameters were assessed: Area of minimal surface spanning annulus (A3), annulus height (h), tenting height (Th), exposed area of anterior (AL), posterior (PL) and both leaflets (BL), ejection fraction of the left ventricle (LV EF), regurgitation volume (RV) and BL/A3, AL/A3, PL/A3 ratios. The normal range of BL/A3 ratio was defined as the average +/- 2SD of control group. The study group was separated into subgroup 1 with BL/A3 ratio within normal values and subgroup 2 with pathological BL/A3 ratio. Corresponding parameters of IMR group were compared to the controls and both subgroups were compared to each other using Student t-test. Results: In IMR group, as compared to the controls, A3, AL, PL, BL as well as BL/A3, AL/A3, PL/A3 ratios and Th were significantly increased, conversely, h and LV EF was significantly decreased. In the subgroup 2 as compared to the subgroup 1 there was significant increase of Th, BL, AL and PL, while EF LV was significantly decreased. There was no significant difference between these subgroups in A3, h and RV. Conclusions: In ischemic MV remodeling two stages were identified without relation to the severity of IMR. The first stage was mainly influenced by the LV dilatation while LV remodeling was more important in the second stage.