title: Relationship between mitral leaflets angles, left ventricular geometry and mitral deformation indices in patients with ischemic mitral regurgitation: imaging by echocardiography and cardiac magnetic resonance.
abstract: Chronic ischemic mitral regurgitation (IMR) is associated with a markedly worse prognosis after myocardial infarction (MI).The study aimed to evaluate the relationship between anterior and posterior mitral leaflet angle (MLA) values, left ventricle remodeling and severity of ischaemic mitral regurgitation (IMR).
  
  
  METHODS
  Forty-two patients (age 63.5 ± 9.7 years, 36 men) with chronic IMR (regurgitant volume, RV > 20 ml; >6 months after MI) underwent transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR) imaging. Anterior and posterior MLA, determined by echocardiography, were correlated with indices of LV remodeling, mitral apparatus deformation and IMR severity by CMR. The anterior and posterior MLA was 25.41 ± 4.28 and 38.37 ± 8.89° (mean ± SD). In 5 patients (11.9%) the posterior MLA was ≥45°. There was a significant correlation between anterior MLA and RV (r = 0.74, P = 0.01). For patients with RV > 30 ml this correlation was stronger (r = 0.97, P = 0.005) and, in addition, there was a correlation between the RV and posterior MLA (r = 0.90, P = 0.037), between tenting area and posterior MLA (r = 0.90, P = 0.04), and between tenting area and anterior MLA (r = 0.82, P = 0.08). With regard to LV remodeling parameters, there was weaker but significant correlation between posterior MLA and LV end-diastolic volume index (r = 0.35, P = 0.031), LV end-systolic volume index (r = 0.37, P = 0.021), stroke volume (r = 0.35, P = 0.03), sphericity index (r = 0.33, P = 0.041). Anterior MLA correlated with wall motion score index (r = 0.41, P = 0.019). Besides, there was a correlation between posterior MLA and left atrial volume (r = 0.41, P = 0.012). Measurement of anterior and posterior MLA may play an important role in evaluating patients with IMR.
authors.affiliation: Department of Cardiac and Vascular Diseases, Jagiellonian University School of Medicine, John Paul II Hospital, Prądnicka 80 Str., 31-202, Kraków, Poland. alesniak@szpitaljp2.krakow.pl
authors.forename: Agata
authors.initials: A
authors.lastname: Leśniak-Sobelga
authors.forename: Ewa
authors.initials: E
authors.lastname: Wicher-Muniak
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kostkiewicz
authors.forename: Maria
authors.initials: M
authors.lastname: Olszowska
authors.forename: Piotr
authors.initials: P
authors.lastname: Musiałek
authors.forename: Piotr
authors.initials: P
authors.lastname: Klimeczek
authors.forename: Paweł
authors.initials: P
authors.lastname: Banyś
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Pasowicz
authors.forename: Wiesława
authors.initials: W
authors.lastname: Tracz
authors.forename: Piotr
authors.initials: P
authors.lastname: Podolec
mesh_terms: D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000473:pathology* / Q000503:physiopathology; D012720:Severity of Illness Index; D020257:Ventricular Remodeling