Etiologic Evaluation of Ischemic Mitral Regurgitation Using Cardiac MRI.
10.4070/kcj.2004.34.6.627
- Author:
Eui Young CHOI
1
;
Young Guk KO
;
Yangsoo JANG
;
Won Heum SHIM
;
Se Joong RIM
;
Namsik CHUNG
;
Seung Yun CHO
;
Kyung Jong YOO
;
Byung Wook CHOI
Author Information
1. Division of Cardiology, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Mitral regurgitation;
Ischemic heart disease;
Magnetic resonance imaging
- MeSH:
Cardiomyopathy, Dilated;
Hemodynamics;
Humans;
Magnetic Resonance Imaging*;
Mitral Valve Insufficiency*;
Myocardial Ischemia;
Myocardium
- From:Korean Circulation Journal
2004;34(6):627-635
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: To evaluate the 3 dimensional geometric changes and the effect of revascularization in patients with ischemic mitral regurgitation (IMR), using cardiac magnetic resonance imaging (MRI). SUBJECTS AND METHODS: Twenty-three patients with IMR, 10 with dilated cardiomyopathy with MR (DCM-MR) and 7 control subjects were enrolled. Hemodynamic indices, severity of MR, geometric parameters of mitral apparatus and myocardial viability were evaluated in all patients, and re-evaluated in the IMR patients 6 months after the revascularization. RESULTS: The mitral tenting area (TAA) (334.1+/-11.7 mm2 vs. 222.9+/-23.0 mm2, p=0.16) and the sum of the tenting angles (TA) (72.9+/-2.9degreevs. 51.5+/-1.1degree p<0.001) at the mid-systolic phase were increased in the IMR compared to the DCM-MR patients. In the IMR patients, the MR severity was positively correlated with the sum of the tethering lengths (r=0.522, p=0.011), LVESV (r=0.551, p=0.006), TAA (r=0.613, p=0.002) and TA (r=0.713, p<0.001). Of the 10 patients with viable myocardium, who had been revascularized without surgical repair of the mitral apparatus, the MR severity was decreased (28.3+/-0.4% vs. 16.5+/-.6%, p=0.009) in 7 patients, with decreases in the sum of the tethering distances (51.2+/-3.9 mm vs. 40.2+/-.1 mm, p=0.034), tenting area (299.2+/-3.8 mm2 vs. 215.0+/-3.6 mm2, p=0.036) and sum of the tenting angles (72.9+/-2.9degreevs. 56.2+/-4.8degree, p=0.015) 6 months after the revascularization. CONCLUSION: IMR was related with the geometric change in the mitral apparatus. Cardiac MRI can be an effective tool for evaluating these geometric changes and when formulating a treatment plan.
