title: Time-motion reconstruction of mitral leaflet motion from two-dimensional echocardiography in mitral valve prolapse.
abstract: To assess the contributions of mitral leaflet billowing and exaggerated systolic mitral anular expansion to posterior motion of mitral leaflets recognized as mitral valve prolapse (MVP) by M-mode echocardiography, time-motion reconstructions of the anteroposterior displacement of points equally spaced along the anterior and posterior mitral leaflets were derived by computer-assisted analysis of 2-dimensional echocardiograms. Late or holosystolic posterior displacement of mitral leaflets, greater than or equal to 2 mm, occurred in the reconstructions from 24 of 24 (100%) patients with MVP with leaflet billowing and in 20 of 24 (83%) patients with MVP without leaflet billowing compared with 4 of 35 (11%) age-sex matched normal adults (both p less than 0.0000002). Posterior motion of the posterior mitral leaflet in time-motion reconstruction was significantly less with respect to the posterior end of the mitral anulus than with respect to the chest wall in patients with nonbillowing MVP (1.6 +/- 1.9 vs 2.7 +/- 1.6, p less than 0.02), but not in those with leaflet billowing (3.6 +/- 1.8 vs 3.9 +/- 1.8, p = not significant), because anular expansion contributed importantly to MVP in the former but not in the latter group. Thus, M-mode echocardiographic patterns of MVP reflect the separate but interacting effects of distinct abnormalities of mitral anular and leaflet dynamics.
authors.affiliation: Department of Medicine, New York Hospital-Cornell Medical Center, New York, New York 10021.
authors.forename: R
authors.initials: R
authors.lastname: Pini
authors.forename: B
authors.initials: B
authors.lastname: Greppi
authors.forename: M J
authors.initials: MJ
authors.lastname: Roman
authors.forename: R
authors.initials: R
authors.lastname: Kramer-Fox
authors.forename: R B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013599:Systole