Dynamic changes of mitral valve annulus geometry at preprocedural CT: relationship with functional classes of regurgitation

European Radiology Experimental

Caterina Beatrice Monti¹  Simone Schaffino²  Valeria Nicoletti³  Caterina Colantoni³  Antonio Esposito³  Francesco De Cobelli³  Fatemeh Darvizeh³  Anna Palmisano³  Davide Vignale³  Eustachio Agricola⁴  Luigi Pannone⁴ 

[1] Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy;Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy;Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy;School of Medicine, Vita-Salute San Raffaele University, Milan, Italy;School of Medicine, Vita-Salute San Raffaele University, Milan, Italy;Echocardiography Unit, School of Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy;

关键词: Computed tomography angiography;    Heart valve prosthesis;    Mitral valve;    Mitral valve insufficiency;    Planning techniques;   

DOI  :  10.1186/s41747-021-00231-3

来源: Springer

【 摘 要 】

BackgroundWe investigated mitral valve annular geometry changes during the cardiac cycle in patients with severe mitral regurgitation (MR) who underwent cardiac computed tomography angiography (CCTA) prior to percutaneous mitral valve replacement or annuloplasty.MethodsFifty-one patients with severe MR and high surgical risk (Carpentier classification: 3 type I, 16 type II, 16 type IIIa, 16 type IIIb) underwent multiphase electrocardiographically gated (0–90%) CCTA, using a second generation dual-source CT scanner, as pre-procedural planning. Twenty-one patients without MR served as controls. The mitral valve annulus was segmented every 10% step of the R-R interval, according to the D-shaped segmentation model, and differences among groups were analysed by t-test or ANOVA.ResultsMitral annular area and diameters were larger in MR patients compared to controls, particularly in type II. Mitral annular area varied in MR patients throughout the cardiac cycle (mean ± standard deviation of maximum and minimum area 15.6 ± 3.9 cm2versus 13.0 ± 3.5 cm2, respectively; p = 0.001), with greater difference between annular areas versus controls (2.59 ± 1.61 cm2 and 1.98 ± 0.6 cm2, p < 0.001). The largest dimension was found in systolic phases (20–40%) in most of MR patients (n = 27, 53%), independent of Carpentier type (I: n = 1, 33%; II: n = 10, 63%; IIIa: n = 8, 50%; IIIb: n = 8, 50%), and in protodiastolic phases (n = 14, 67%) for the control group.ConclusionsIn severe MR, mitral annular area varied significantly throughout the cardiac cycle, with a tendency towards larger dimensions in systole.

【 授权许可】

CC BY