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Huang R, Jin J, Zhang P, Yan K, Zhang H, Chen X, He W, Guan H, Liao Z, Xiao H, Li Y, Li H. Use of speckle tracking echocardiography in evaluating cardiac dysfunction in patients with acromegaly: an update. Front Endocrinol (Lausanne) 2023; 14:1260842. [PMID: 37929035 PMCID: PMC10623426 DOI: 10.3389/fendo.2023.1260842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
In recent years, cardiovascular disease has garnered increasing attention as the second leading cause of death in individuals with acromegaly, following malignancy. Identifying cardiac dysfunction early in acromegaly patients for timely intervention has become a focal point of clinical research. Speckle tracking echocardiography, a well-established ultrasound technique, surpasses conventional Doppler ultrasound in its sensitivity to assess both local and global cardiac mechanics. It can accurately detect subclinical and clinical myocardial dysfunction, including myocardial ischemia, ventricular hypertrophy, and valvular changes. Over the past five years, the use of speckle tracking echocardiography in acromegaly patients has emerged as a novel approach. Throughout the cardiac cycle, speckle tracking echocardiography offers a sensitive evaluation of the global and regional myocardial condition by quantifying the motion of myocardial fibres in distinct segments. It achieves this independently of variations in ultrasound angle and distance, effectively simulating the deformation of individual ventricles across different spatial planes. This approach provides a more accurate description of changes in cardiac strain parameters. Importantly, even in the subclinical stage when ejection fraction remains normal, the strain parameters assessed by speckle tracking echocardiography hold a good predictive value for the risk of cardiovascular death and hospitalization in acromegaly patients with concomitant cardiovascular disease. This information aids in determining the optimal timing for interventional therapy, offering important insights for cardiac risk stratification and prognosis. In the present study, we comprehensively reviewed the research progress of speckle tracking echocardiography in evaluating of cardiac dysfunction in acromegaly patients, to pave the way for early diagnosis of acromegaly cardiomyopathy.
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Affiliation(s)
- Rong Huang
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jiewen Jin
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Pengyuan Zhang
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Kemin Yan
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hanrong Zhang
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xin Chen
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wei He
- Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hongyu Guan
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhihong Liao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hai Li
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Papadopoulos K, Ikonomidis I, Özden Ö, Tzikas A, Arampatzis CA, Vannan MA. Level of agreement between three-dimensional transthoracic and transesophageal echocardiography for mitral annulus evaluation: A feasibility and comparison study. Echocardiography 2022; 39:1512-1521. [PMID: 36350103 DOI: 10.1111/echo.15481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/17/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Mitral annulus assessment is of utmost importance for the management of patients with mitral valve (MV) abnormalities, as it helps to determine the decision for surgical or transcatheter treatment. Three-dimensional (3D) transesophageal echocardiography (TOE) has been the only reliable echocardiographic method for the evaluation of the mitral annulus by now. However, newer transthoracic echocardiography (TTE) 3D probes have enabled to provide accurate measurements as well and become a valuable tool when TOE is contraindicated. The aim of this study is to assess the feasibility of 3D TTE analysis of mitral annulus and the level of agreement with 3D TOE measurements. METHODS A total of 121 consecutive patients were assessed with 3D TTE and TOE. All mitral annulus parameters were retrospectively analyzed with the dedicated 4D autoMVQ application. Bland-Altman analysis and intraclass correlation coefficient were used for the comparison and agreement between the two methods. Half of our patients had normal mitral valves and served as control group, while the other half had various mitral valve pathologies. RESULTS AutoMVQ analysis was not feasible in 11 out of 121 TTE examinations (91% feasibility) and in 4 out of 121 TOE examinations (96% feasibility). Mitral annular area and perimeter were slightly larger in TTE than those measured by TOE (12.7 ± 3.6 vs. 12.4 ± 3.2 cm2 for area and 12.7 ± 1.7 vs. 12.5 ± 1.6 cm for perimeter), however still showing strong correlation (r = .942 and r = .922, respectively). The majority of mitral valve measurements (anterior-posterior, medial-lateral and commissural diameter, aorto-mitral angle and anterior leaflet length) were similar among the two methods with strong correlation (r > .80). Inter-trigonal distance, posterior leaflet length and tenting height showed weaker agreement between TTE and TOE (r = .687, r = .687, r = .634, respectively). Mitral annular dimensions (by 3D area) were found to be significantly larger in patients with MV pathology (13.5 ± 3.5 vs. 11 ± 2.3 cm2 ), atrial fibrillation (14.4 ± 3 vs. 11.4 ± 2.8 cm2 ), left ventricular (13.8 ± 3.1 vs. 11.7 ± 3.1cm2 ) and left atrial dilatation (13 ± 3.3 vs. 10.6 ± 2.3cm2 ) compared to the individuals in the control group (p < .001 for all comparisons). CONCLUSIONS Assessment of the MV with 3D TTE with dedicated MVQ software is feasible and accurate, showing strong correlation and agreement with TOE measurements.
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Affiliation(s)
| | - Ignatios Ikonomidis
- Echocardiography Laboratory, 2nd Cardiology Department, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Özge Özden
- Cardiology Department, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Apostolos Tzikas
- Cardiology Department, European Interbalkan Medical center, Thessaloniki, Greece
| | | | - Manni A Vannan
- Structural and Valvular Center of Excellence, Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
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Henry MP, Cotella J, Mor-Avi V, Addetia K, Miyoshi T, Schreckenberg M, Blankenhagen M, Hitschrich N, Amuthan V, Citro R, Daimon M, Gutiérrez-Fajardo P, Kasliwal R, Kirkpatrick JN, Monaghan MJ, Muraru D, Ogunyankin KO, Park SW, Tude Rodrigues AC, Ronderos R, Sadeghpour A, Scalia G, Takeuchi M, Tsang W, Tucay ES, Zhang M, Lang RM, Asch FM. Three-Dimensional Transthoracic Static and Dynamic Normative Values of the Mitral Valve Apparatus: Results from the Multicenter World Alliance Societies of Echocardiography Study. J Am Soc Echocardiogr 2022; 35:738-751.e1. [PMID: 35245668 DOI: 10.1016/j.echo.2022.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/31/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent advances in mitral valve (MV) percutaneous interventions have escalated the need for a more quantitative and comprehensive assessment of the MV, which can be best achieved using three-dimensional echocardiography. Understanding normal valve size, structure, and function is essential for differentiation of healthy from disease states. The aims of this study were to establish normative values for MV apparatus size and morphology and to determine how they vary across age, sex, and race groups using data from the World Alliance Societies of Echocardiography Normal Values Study. METHODS Three-dimensional volumetric data sets obtained on transthoracic echocardiography in 748 normal subjects (51% men) were analyzed using commercial MV analysis software (TomTec Imaging Systems) to determine annular and leaflet dimensions and areas. The subjects were divided into groups by sex (378 men and 370 women) and age (18 to 40 years [n = 266], 41 to 65 years [n = 249], and >65 years [n = 233]) to identify sex- and age-related differences. In addition, differences among black, white, and Asian populations were studied. Inter- and intraobserver variability was assessed in a subset of 30 subjects and expressed as mean absolute difference between pairs of repeated measurements. RESULTS Compared with women, men had larger annular size measurements, larger tenting size parameters, and larger leaflet length and area. Compared with the black and white populations, the Asian population showed significantly smaller mitral annular size. Although many of the age, sex, and race differences in MV parameters were statistically significant, they were comparable with or smaller than the corresponding measurement variability. Indexing to body surface area and height did not eliminate these differences consistently, suggesting that parameters may need to be indexed according to their dimensionality. CONCLUSIONS This analysis of the World Alliance Societies of Echocardiography data provides normative values of mitral apparatus size and morphology. Although sex- and age-related differences were noted, they need to be interpreted with caution in view of the associated measurement variability.
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Affiliation(s)
| | | | | | | | - Tatsuya Miyoshi
- MedStar Health Research Institute, Washington, District of Columbia
| | | | | | | | | | | | | | | | | | | | | | - Denisa Muraru
- Instituto Auxologico Italiano, IRCCS, San Luca Hospital and University of Milano-Bicocca, Milan, Italy
| | | | | | | | - Ricardo Ronderos
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Masaaki Takeuchi
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Wendy Tsang
- Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - Mei Zhang
- Qilu Hospital of Shandong University, Jinan, China
| | | | - Federico M Asch
- MedStar Health Research Institute, Washington, District of Columbia
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Nemes A, Kormányos Á, Domsik P, Kalapos A, Lengyel C, Ambrus N, Valkusz Z. Mitral annulus is dilated with preserved function in acromegaly regardless of its activity: Insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.repce.2020.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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5
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Marta L. Mitral annular function in acromegaly: Still a lot to learn. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.repce.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nemes A, Kormányos Á, Domsik P, Kalapos A, Lengyel C, Ambrus N, Valkusz Z. Mitral annulus is dilated with preserved function in acromegaly regardless of its activity: Insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study. Rev Port Cardiol 2021; 40:253-258. [PMID: 33663867 DOI: 10.1016/j.repc.2020.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/11/2020] [Accepted: 07/08/2020] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION AND OBJECTIVE Acromegaly is a rare, chronic and slowly developing endocrine disorder caused by hypersecretion of human growth hormone and consequently of insulin-like growth factor-1 during adulthood. The present study was conducted to assess mitral annular (MA) size and function between acromegalic patients and age- and gender-matched healthy controls by three-dimensional speckle-tracking echocardiography (3D-STE). It also aimed to examine whether activity of the disease has any effect on MA parameters. METHODS This study included 27 patients with acromegaly, three of whom were excluded due to inferior image quality. The mean age of the remaining 24 patients was 55.7±14.0 years and seven were male. Complete two-dimensional Doppler echocardiography and 3D-STE were performed in all cases. RESULTS Significantly increased end-diastolic and end-systolic MA diameter (2.81±0.36 cm vs. 2.44±0.34 cm and 2.00±0.32 cm vs. 1.65±0.37 cm, respectively), area (9.67±2.33 cm2 vs. 7.38±1.93 cm2 and 5.14±1.62 cm2 vs. 3.74±1.19 cm2, respectively) and perimeter (11.76±1.42 cm vs. 10.27±1.33 cm and 8.61±1.23 cm vs. 7.36±1.10 cm, respectively) were demonstrated in acromegalic patients compared with control subjects. MA functional parameters were not significantly altered compared to those of healthy individuals. CONCLUSIONS MA dilation could be seen in acromegaly regardless of its activity. Acromegaly is not associated with MA functional impairment.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Centre, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Centre, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Centre, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- 1st Department of Medicine, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Centre, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Zsuzsanna Valkusz
- 1st Department of Medicine, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Marta L. Mitral annular function in acromegaly: Still a lot to learn. Rev Port Cardiol 2021; 40:259-260. [PMID: 33637360 DOI: 10.1016/j.repc.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Liliana Marta
- Department of Cardiology, Hospital Beatriz Ângelo, Loures, Portugal.
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8
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Nemes A, Kovács Z, Kormányos Á, Domsik P, Kalapos A, Ajtay Z, Lengyel C. Left ventricular apical rotation is associated with mitral annular function in healthy subjects. Results from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study. Physiol Int 2020; 107:145-154. [PMID: 32598330 DOI: 10.1556/2060.2020.00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 12/09/2019] [Indexed: 11/19/2022]
Abstract
Introduction Left ventricular (LV) twist is considered an essential part of LV function due to oppositely directed LV basal and apical rotations. Several factors could play a role in determining LV rotational mechanics in normal circumstances. This study aimed to investigate the relationship between LV rotational mechanics and mitral annular (MA) size and function in healthy subjects. Methods The study comprised 118 healthy adult volunteers (mean age: 31.5 ± 11.8 years, 50 males). All subjects had undergone complete two-dimensional (2D) Doppler echocardiography and three-dimensional speckle-tracking echocardiography (3DSTE) at the same time by the same echocardiography equipment. Results The normal mean LV apical and basal rotations proved to be 9.57 ± 3.33 and -3.75 ± 1.98°, respectively. LV apical rotation correlated with end-systolic MA diameter, area, perimeter, fractional area change, and fractional shortening, but did not correlate with any end-diastolic mitral annular morphologic parameters. The logistic regression model identified MA fractional area change as an independent predictor of ≤6° left ventricular apical rotation (P < 0.003). Conclusions Correlations could be detected between apical LV rotation and end-systolic MA size and function, suggesting relationships between MA dimensions and function and LV rotational mechanics.
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Affiliation(s)
- A Nemes
- 12nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Z Kovács
- 2Department of Cardiology, Szent Rókus Hospital, Baja, Hungary
| | - Á Kormányos
- 12nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - P Domsik
- 12nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - A Kalapos
- 12nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Z Ajtay
- 3Vilmos Zsigmondy SPA Hospital, Harkány, Hungary.,4Heart Institute, Medical School, University of Pécs, Pécs, Hungary
| | - C Lengyel
- 51st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Wang W, Wang Z, Li J, Gong K, Zhao L, Tang G, Fu X. The impact of different geometric assumption of mitral annulus on the assessment of mitral regurgitation volume by Doppler method. Cardiovasc Ultrasound 2020; 18:5. [PMID: 32005178 PMCID: PMC6995243 DOI: 10.1186/s12947-020-0187-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mitral regurgitation volume (MRvol) by quantitative pulsed Doppler (QPD) method previously recommended suffers from geometric assumption error because of circular geometric assumption of mitral annulus (MA). Therefore, the aim of this study was to evaluate the impact of different geometric assumption of MA on the assessment of MRvol by two-dimensional transthoracic echocardiographic QPD method. Methods This study included 88 patients with varying degrees of mitral regurgitation (MR). The MRvol was evaluated by QPD method using circular or ellipse geometric assumption of MA. MRvol derived from effective regurgitant orifice area by real time three-dimensional echocardiography (RT3DE) multiplied by MR velocity-time integral was used as reference method. Results Assumption of a circular geometry of MA, QPD-MAA4C and QPD-MAPLAX overestimated the MRvol by a mean difference of 10.4 ml (P < 0.0001) and 22.5 ml (P < 0.0001) compared with RT3DE. Assumption of an ellipse geometry of MA, there was no significant difference of MRvol (mean difference = 1.7 ml, P = 0.0844) between the QPD-MAA4C + A2C and the RT3DE. Conclusions Assuming that the MA was circular geometry previously recommended, the MRvol by QPD-MAA4C was overestimated compared with the reference method. However, assuming that the MA was ellipse geometry, the MRvol by the QPD-MAA4C + A2C has no significant difference with the reference method.
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Affiliation(s)
- Wugang Wang
- Department of Echocardiography, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, China
| | - Zhibin Wang
- Department of Echocardiography, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, China
| | - Junfang Li
- Department of Echocardiography, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, China
| | - Kun Gong
- Department of Echocardiography, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, China
| | - Liang Zhao
- Department of Echocardiography, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, China
| | - Guozhang Tang
- Department of Echocardiography, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, China
| | - Xiuxiu Fu
- Department of Echocardiography, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, China.
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Nemes A, Kovács Z, Kormányos Á, Domsik P, Kalapos A, Piros GÁ, Kemény L, Forster T, Szolnoky G. The mitral annulus in lipedema: Insights from the three‐dimensional speckle‐tracking echocardiographic MAGYAR‐Path Study. Echocardiography 2019; 36:1482-1491. [DOI: 10.1111/echo.14429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 06/05/2019] [Accepted: 06/11/2019] [Indexed: 12/31/2022] Open
Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Centre Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
| | - Zsolt Kovács
- Department of Cardiology Szent Rókus Hospital Baja Hungary
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Centre Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Centre Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
| | - Györgyike Á. Piros
- 2nd Department of Medicine and Cardiology Centre Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
| | - Tamás Forster
- 2nd Department of Medicine and Cardiology Centre Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
| | - Győző Szolnoky
- Department of Dermatology and Allergology Albert Szent‐Györgyi Clinical Center, University of Szeged Szeged Hungary
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de Groot-de Laat LE, McGhie J, Ren B, Frowijn R, Oei FB, Geleijnse ML. A Modified Echocardiographic Classification of Mitral Valve Regurgitation Mechanism: The Role of Three-dimensional Echocardiography. J Cardiovasc Imaging 2019; 27:187-199. [PMID: 31161753 PMCID: PMC6669177 DOI: 10.4250/jcvi.2019.27.e29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/27/2019] [Accepted: 04/08/2019] [Indexed: 12/22/2022] Open
Abstract
In this report, we provide an overview of a new, updated echocardiographic classification of mitral regurgitation mechanisms to provide a more comprehensive and detailed assessment of mitral valve disorders. This is relevant to modern mitral valve repair techniques, with special attention to the added value of 3D-echocardiography.
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Affiliation(s)
- Lotte E de Groot-de Laat
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Jackie McGhie
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ben Ren
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - René Frowijn
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Frans B Oei
- Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marcel L Geleijnse
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
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12
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Aruta P, Muraru D, Guta AC, Mihaila S, Ruozi N, Palermo C, Elnagar B, Iliceto S, Badano LP. Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation. Cardiovasc Ultrasound 2018; 16:27. [PMID: 30314517 PMCID: PMC6186037 DOI: 10.1186/s12947-018-0145-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/24/2018] [Indexed: 12/11/2022] Open
Abstract
Background Transcatheter mitral valve replacement (TMVR) is a new therapeutic option for high surgical risk patients with mitral regurgitation (MR). Mitral valve (MV) geometry quantification is of paramount importance for success of the procedure and transthoracic 3D echocardiography represents a useful screening tool. Accordingly, we sought to asses MV geometry in patients with functional MR (FMR) that would potentially benefit of TMVR, focusing on the comparison of mitral annulus (MA) geometry between patients with ischemic (IMR) and non ischemic mitral regurgitation (nIMR). Methods We retrospectively selected 94 patients with severe FMR: 41 (43,6%) with IMR and 53 (56,4%) with nIMR. 3D MA analysis was performed on dedicated transthoracic 3D data sets using a new, commercially-available software package in two moments of the cardiac cycle (early-diastole and mid-systole). We measured MA dimension and geometry parameters, left atrial and left ventricular volumes. Results Maximum (MA area 10.7 ± 2.5 cm2 vs 11.6 ± 2.7 cm2, p > 0.05) and the best fit plane MA area (9.9 ± 2.3 cm2 vs 10.7 ± 2.5 cm2, p > 0.05, respectively) were similar between IMR and nIMR. nIMR patients showed larger mid-systolic 3D area (9.8 ± 2.3 cm2 vs 10.8 ± 2.7 cm2, p < 0.05) and perimeter (11.2 ± 1.3 cm vs 11.8 ± 1.5 cm, p < 0.05) with longer and larger leaflets, and wider aorto-mitral angle (135 ± 10° vs 141 ± 11°, p < 0.05). Conversely, the area of MA at the best fit plane did not differ between IMR and nIMR patients (9 ± 1.1 cm2 vs 9.9 ± 1.5 cm2, p > 0.05). Conclusions Patients with ischemic and non-ischemic etiology of FMR have similar maximum dimension, yet systolic differences between the two groups should be taken into account to tailor prosthesis’s selection. Trial registration N.A.
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Affiliation(s)
- Patrizia Aruta
- Department of Cardiac, Thoracic and Vascular Science, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Denisa Muraru
- Department of Cardiac, Thoracic and Vascular Science, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Andrada Camelia Guta
- Department of Cardiac, Thoracic and Vascular Science, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.,University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Sorina Mihaila
- University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Niccolò Ruozi
- Department of Cardiac, Thoracic and Vascular Science, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Chiara Palermo
- Department of Cardiac, Thoracic and Vascular Science, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | | | - Sabino Iliceto
- Department of Cardiac, Thoracic and Vascular Science, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Luigi P Badano
- Department of Cardiac, Thoracic and Vascular Science, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
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Nemes A, Piros GÁ, Domsik P, Kalapos A, Lengyel C, Várkonyi TT, Orosz A, Forster T. Changes in mitral annular morphology and function in young patients with type 1 diabetes mellitus-results from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study. Quant Imaging Med Surg 2015; 5:815-21. [PMID: 26807363 PMCID: PMC4700242 DOI: 10.3978/j.issn.2223-4292.2015.12.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/13/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Alterations in mitral annular size and function could be demonstrated in cardiomyopathies and ischaemic heart disease. The present study was designed to evaluate mitral annulus (MA) morphology and function in young type 1 diabetes mellitus (T1DM) patients by three-dimensional speckle tracking echocardiography (3DSTE) and to compare their results to matched healthy controls. METHODS The study comprised 18 patients with T1DM (mean age: 33.0±8.0 years). Their results were compared to that of 20 age- and gender-matched healthy controls (mean age: 37.8±10.9 years). Complete two-dimensional (2D) Doppler echocardiography and 3DSTE have been performed in all cases. RESULTS No significant differences could be demonstrated in demographic and standard echocardiographic parameters between the groups. Significantly enlarged diastolic MA diameter (2.87±0.27 mm vs. 2.58±0.32 mm, P=0.01), MA diameter index 1.61±0.20 cm/m(2) vs. 1.30±0.39 cm/m(2), P=0.008, and MA area index (4.81±0.88 cm(2)/m(2) vs. 3.91±1.35 cm(2)/m(2), P=0.03) could be demonstrated in T1DM together with augmented MA fractional shortening (28.64±9.63% vs. 20.35±12.50%, P=0.05). CONCLUSIONS Early alterations in MA size and function could be demonstrated in young patients with T1DM by 3DSTE.
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Normal mitral annulus dynamics and its relationships with left ventricular and left atrial function. Int J Cardiovasc Imaging 2014; 31:279-90. [DOI: 10.1007/s10554-014-0547-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/03/2014] [Indexed: 01/08/2023]
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Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T, Nemes A. [Correlations between mitral annular and left atrial function as assessed by three-dimensional speckle-tracking echocardiography in healthy volunteers. Results from the MAGYAR-Healthy Study]. Orv Hetil 2014; 155:1517-23. [PMID: 25217768 DOI: 10.1556/oh.2014.29975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Left atrium is a heart chamber with dinamic motion communicating with left ventricle through the mitral valve and its annulus. AIM The aim of the present study was to analyse whether relationships could exist between three-dimensional speckle-tracking echocardiography-derived morphologic and functional parameters of the left atrium and mitral annulus in healthy subjects. METHOD The present study comprised 35 healthy volunteers. Maximum (Vmax) and minimum (Vmin) left atrial volumes and left atrial volume before atrial contraction (VpreA) were measured, and several functional parameters based on these volumes were calculated in all cases. Morphologic and functional characteristics of the mitral annulus were also determined. RESULTS While Vmax showed correlations with both systolic and diastolic mitral annulus parameters, Vmin-VpreA correlated with only systolic ones. While total left atrial stroke volume correlated with both systolic and diastolic mitral annular parameters, passive left atrial stroke volume showed correlations only with diastolic ones. CONCLUSIONS Correlations exist between left atrial and mitral annular morphological and functional characteristics in healthy subjects.
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Affiliation(s)
- Péter Domsik
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Anita Kalapos
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Csaba Lengyel
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ I. Belgyógyászati Klinika Szeged
| | - Andrea Orosz
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ Farmakológiai és Farmakoterápiás Intézet Szeged
| | - Tamás Forster
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Attila Nemes
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
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Mihăilă S, Muraru D, Piasentini E, Miglioranza MH, Peluso D, Cucchini U, Iliceto S, Vinereanu D, Badano LP. Quantitative Analysis of Mitral Annular Geometry and Function in Healthy Volunteers Using Transthoracic Three-Dimensional Echocardiography. J Am Soc Echocardiogr 2014; 27:846-57. [DOI: 10.1016/j.echo.2014.04.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Indexed: 10/25/2022]
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17
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Ren B, de Groot–de Laat LE, McGhie J, Vletter WB, ten Cate FJ, Geleijnse ML. Geometric Errors of the Pulsed-Wave Doppler Flow Method in Quantifying Degenerative Mitral Valve Regurgitation: A Three-Dimensional Echocardiography Study. J Am Soc Echocardiogr 2013; 26:261-9. [DOI: 10.1016/j.echo.2012.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Indexed: 11/28/2022]
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Nemes A, Forster T. Three-dimensional echocardiography for the evaluation of left ventricular noncompaction. J Am Soc Echocardiogr 2012; 25:805-6. [PMID: 22658560 DOI: 10.1016/j.echo.2012.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Indexed: 11/30/2022]
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Mitral valve repair and annular motion: is less really more? J Am Soc Echocardiogr 2011; 24:1243-5. [PMID: 22018496 DOI: 10.1016/j.echo.2011.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Saito K, Okura H, Watanabe N, Imai K, Tamada T, Koyama T, Hayashida A, Neishi Y, Kawamoto T, Yoshida K. Quantification of mitral valve apparatus by three-dimensional transesophageal echocardiography: in vitro validation study comparing two different analysis systems. J Echocardiogr 2011; 9:130-6. [PMID: 27277289 DOI: 10.1007/s12574-011-0091-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 04/04/2011] [Accepted: 04/12/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Ken Saito
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
| | - Hiroyuki Okura
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Nozomi Watanabe
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Koichiro Imai
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Tomoko Tamada
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Terumasa Koyama
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Akihiro Hayashida
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Yoji Neishi
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Takahiro Kawamoto
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Kiyoshi Yoshida
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
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Little SH, Ben Zekry S, Lawrie GM, Zoghbi WA. Dynamic Annular Geometry and Function in Patients with Mitral Regurgitation: Insight From Three-Dimensional Annular Tracking. J Am Soc Echocardiogr 2010; 23:872-9. [DOI: 10.1016/j.echo.2010.06.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Indexed: 11/16/2022]
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Three-Dimensional Transesophageal Echocardiography Is a Major Advance for Intraoperative Clinical Management of Patients Undergoing Cardiac Surgery. Anesth Analg 2010; 110:1548-73. [DOI: 10.1213/ane.0b013e3181d41be7] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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23
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Nemes A, Geleijnse ML, Soliman OII, Vletter WB, McGhie JS, Forster T, Ten Cate FJ. [Evaluation of the mitral valve by transthoracic real-time three-dimensional echocardiography]. Orv Hetil 2010; 151:854-63. [PMID: 20462845 DOI: 10.1556/oh.2010.28874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Recently, echocardiography is the most widely used routine non-invasive diagnostic method, with which morphology and function of the mitral valve can be characterized. The aim of this review is to demonstrate the role of one of the newest echocardiographic developments, the transthoracic real-time three-dimensional echocardiography in the evaluation of mitral valve.
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Affiliation(s)
- Attila Nemes
- Erasmus MC, Thoraxcentrum, Kardiológiai Klinika, Rotterdam.
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Nemes A, Geleijnse ML, Soliman OII, Anwar AM, Vletter WB, McGhie JS, Csanády M, Forster T, Ten Cate FJ. [The role of real-time three-dimensional echocardiography in the evaluation of hypertrophic cardiomyopathy]. Orv Hetil 2009; 150:1925-31. [PMID: 19812010 DOI: 10.1556/oh.2009.28710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hypertrophic cardiomyopathy is a relatively common hereditary disorder, which is associated with cardiac morphologic and functional alterations. Echocardiography is a non-invasive, simple and easy-to-learn method to evaluate patients with cardiomyopathy. The aim of this review paper is to demonstrate the possible diagnostic role of one of the newest echocardiographic development, the real-time 3-dimensional echocardiography in the evaluation of hypertrophic cardiomyopathy.
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Affiliation(s)
- Attila Nemes
- Erasmus MC, Thoraxcentrum Kardiológiai Klinika Rotterdam.
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Obase K, Watanabe N, Yoshida K. Real-time three-dimensional echocardiographic evaluation of the mitral valve. CURRENT CARDIOVASCULAR IMAGING REPORTS 2009. [DOI: 10.1007/s12410-009-0047-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shiota T. 3D echocardiography: The present and the future. J Cardiol 2008; 52:169-85. [DOI: 10.1016/j.jjcc.2008.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Accepted: 09/04/2008] [Indexed: 12/14/2022]
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Nemes A, Geleijnse ML, Soliman OI, Anwar AM, Bosch JG, Krenning BJ, Yap SC, Vletter WB, McGhie JS, Forster T, Csanády M, ten Cate FJ. Real-time 3-dimensional echocardiography – can there be one more dimension? Orv Hetil 2007; 148:2451-60. [DOI: 10.1556/oh.2007.28230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A kardiológiai betegek ellátásában a noninvazív vizsgáló módszereknek alapvető jelentőségük van. Elméletileg a szív akkor vizsgálható tökéletesen, ha természetének megfelelően három dimenzióban rögzítjük a szívciklus szerint. A második generációs, immár real-time (vagyis valós idejű) háromdimenziós echokardiográfok elméletileg optimális lehetőséget nyújtanak a cardialis struktúrák háromdimenziós elemzésére. Real-time 3-dimenziós echokardiográfia során pontosan mérhetők a kamrai és pitvari térfogatok, valamint a kamrai izomtömeg. A billentyűk és a congenitalis abnormalitások ‘en-face’ vizsgálhatók. Használhatóságát terheléses protokollok alkalmazása mellett igazolták. A jelen összefoglaló közlemény célja a módszer bemutatása, lehetséges előnyeinek tisztázása a jelenleg még fennálló technológiai korlátok bemutatásával együtt.
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Affiliation(s)
| | | | | | | | - Johan G. Bosch
- 1 Erasmus MC, Thoraxcentrum Kardiológiai Klinika Rotterdam Hollandia
| | | | - Sing-Chien Yap
- 1 Erasmus MC, Thoraxcentrum Kardiológiai Klinika Rotterdam Hollandia
| | - Wim B. Vletter
- 1 Erasmus MC, Thoraxcentrum Kardiológiai Klinika Rotterdam Hollandia
| | - Jackie S. McGhie
- 1 Erasmus MC, Thoraxcentrum Kardiológiai Klinika Rotterdam Hollandia
| | - Tamás Forster
- 2 Szegedi Tudományegyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Miklós Csanády
- 2 Szegedi Tudományegyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
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Nemes A, Anwar AM, Caliskan K, Soliman OII, van Dalen BM, Geleijnse ML, ten Cate FJ. Evaluation of left atrial systolic function in noncompaction cardiomyopathy by real-time three-dimensional echocardiography. Int J Cardiovasc Imaging 2007; 24:237-42. [PMID: 17849237 PMCID: PMC2233707 DOI: 10.1007/s10554-007-9261-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Accepted: 08/20/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Noncompaction cardiomyopathy (NCCM) is a rare disorder with persistance of the embryonic pattern of myoarchitecture. NCCM is characterized by loosened, spongy myocardium associated with a high incidence of systolic and diastolic left ventricular (LV) dysfunction and heart failure (HF). It is known that LV dysfunction contributes to elevated left atrial (LA) and pulmonary vascular pressures, however atrial function has not been examined in NCCM. The objective of the present study was to assess LA systolic function characterized by LA ejection force (LAEF) in NCCM patients using real-time three-dimensional echocardiography (RT3DE) and to compare to control subjects. METHODS The study comprised 17 patients with an established diagnosis of NCCM and their results were compared to 17 healthy age-matched controls with no evidence of cardiovascular disease. Forty-one percent of NCCM patients were in NYHA functional class II / III HF. Previously proposed echocardiographic diagnostic criteria for NCCM were used. All patients underwent conventional two-dimensional echocardiography and RT3DE. LAEF was measured based on MA annulus diameter (LAEF 3D-MAD) and area (LAEF 3D-MAA) using RT3DE. RESULTS The presence and severity of mitral regurgitation were more frequent in NCCM patients than in control subjects. LV diameters and mitral annulus were significantly increased in NCCM patients. Compared with control subjects, both LAEF 3D-MAD (3.8 +/- 2.2 vs 2.3 +/- 1.0 kdyne, P < 0.05) and LAEF 3D-MAA (12.7 +/- 7.6 vs 4.9 +/- 2.1 kdyne, P < 0.01) were significantly increased in NCCM patients. CONCLUSIONS LAEF as a characteristic of LA systolic function is increased in NCCM patients compared to normal individuals. These results can suggest compensating left atrial work against the dysfunctional LV in NCCM patients.
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Affiliation(s)
- Attila Nemes
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
- 2nd Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | - Ashraf M. Anwar
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
- Department of Cardiology, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt
| | - Kadir Caliskan
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
| | - Osama I. I. Soliman
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
- Department of Cardiology, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt
| | - Bas M. van Dalen
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
| | - Marcel L. Geleijnse
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
| | - Folkert J. ten Cate
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
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