title: Mitral Annular Kinetics, Left Atrial, and Left Ventricular Diastolic Function Post Mitral Valve Repair in Degenerative Mitral Regurgitation.
abstract: OBJECTIVE
  The relationship of mitral annular (MA) kinetics to left ventricular (LV) and left atrial (LA) function before and after mitral valve (MV) repair has not been well studied. Here we sought to provide comprehensive analysis that relates to MA motions, and LA and LV diastolic function post MV repair.
  
  
  METHODS
  Three-dimensional analyses of mitral annular motion, LA function, and LV volumetric and diastolic strain rates were performed on 35 degenerative mitral regurgitation (MR) patients at baseline and 1-year post MV repair, and 51 normal controls, utilizing cardiac magnetic resonance imaging with tissue tagging.
  
  
  RESULTS
  All had normal LV ejection fraction (EF) at baseline. LV and LA EFs decreased 1-year post-surgery vs. controls. LV early diastolic myocardial strain rates decreased post-surgery along with decreases in normalized early diastolic filling rate, E/A ratio, and early diastolic MA relaxation rates. Post-surgical LA late active kick remained higher in MR patients vs. control. LV and LA EFs were significantly associated with peak MA centroid to apex shortening. Furthermore, during LV systolic phase, peak LV ejection and LA filling rates were significantly correlated with peak MA centroid to apex shortening rate, respectively. While during LV diastolic phase, both peak early diastolic MA centroid to apex relaxation rate and LA ejection rate were positively significantly associated with LV peak early diastolic filling rate.
  
  
  CONCLUSIONS
  MA motion is significantly associated with LA and LV function. Mitral annular motion, left atrial function, and LV diastolic strain rates are still impaired 1 year post MV repair. Long-term effects of these impairments should be prospectively evaluated.
authors.affiliation: Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham , Birmingham, AL , USA.
authors.forename: Chun G
authors.initials: CG
authors.lastname: Schiros
authors.affiliation: Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham , Birmingham, AL , USA.
authors.forename: Mustafa I
authors.initials: MI
authors.lastname: Ahmed
authors.affiliation: Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham , Birmingham, AL , USA ; Alfred Health , Melbourne, VIC , Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: McGiffin
authors.affiliation: Department of Electrical and Computer Engineering, Samuel Ginn College of Engineering, Auburn University , Auburn, AL , USA.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham , Birmingham, AL , USA ; Birmingham Veteran Affairs Medical Center , Birmingham, AL , USA.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Lloyd
authors.affiliation: Department of Biostatistics, The University of Alabama at Birmingham , Birmingham, AL , USA.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Aban
authors.affiliation: Department of Electrical and Computer Engineering, Samuel Ginn College of Engineering, Auburn University , Auburn, AL , USA.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Denney
authors.affiliation: Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham , Birmingham, AL , USA ; Birmingham Veteran Affairs Medical Center , Birmingham, AL , USA.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Dell'Italia
authors.affiliation: Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham , Birmingham, AL , USA ; Birmingham Veteran Affairs Medical Center , Birmingham, AL , USA.
authors.forename: Himanshu
authors.initials: H
authors.lastname: Gupta
keywords: isolated mitral regurgitation; left atrial function; left ventricular diastolic function; mitral annular kinetics; mitral valve repair