Dynamic change in mitral annular area and motion during percutaneous mitral annuloplasty for ischemic mitral regurgitation: preliminary animal study with real-time 3-dimensional echocardiography.
We used a novel 3-dimensional (3D) echocardiographic technique to evaluate the impact of a coronary sinus-based percutaneous transvenous mitral annuloplasty (PTMA) on dynamic changes in mitral annular geometry and motion during the cardiac cycle in 8 sheep with ischemic mitral regurgitation. Using real-time 3D echocardiographic data before and after PTMA, 10 points along the saddle-shaped annulus were identified. For every 3D volume/frame during a cardiac cycle, we assessed mitral annular area and excursion defined as the traveling distance of the annular center. The PTMA device reduced both minimum and maximal mitral annular area (9.5 +/- 0.9-7.0 +/- 0.6 and 12.8 +/- 1.3-9.8 +/- 1.5 cm(2), P < .001 for both, respectively) with reduction of mitral regurgitation jet area (5.1 +/- 2.3-1.2 +/- 0.8 cm(2), P < .001), whereas it did not significantly impair mitral annular excursion amplitude (8.3 +/- 1.1-7.0 +/- 1.9 mm, P = .13). This 3D echocardiographic method noninvasively enabled dynamic study of mitral annular geometry and motion with quantitative analysis of the impact of PTMA.
Daimon
Masao
M
Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Gillinov
A Marc
AM
Liddicoat
John R
JR
Saracino
Giuseppe
G
Fukuda
Shota
S
Koyama
Yasushi
Y
Hayase
Motoya
M
Cohn
William E
WE
Ellis
Stephen G
SG
Thomas
James D
JD
Shiota
Takahiro
T
D000818:Animals; D002404:Catheterization / Q000379:methods*; D004195:Disease Models, Animal; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005500:Follow-Up Studies; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D009200:Myocardial Contraction / Q000502:physiology*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012756:Sheep; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*