Mechanisms of atrial mitral regurgitation: insights using 3D transoesophageal echo

• DOI: 10.1093/ehjci/jet191
• Publication Date: 2013-10-22T00:35:01Z
• Authors: L. Ring; D. P. Dutka; F. C. Wells; S. P. Fynn; L. M. Shapiro; B. S. Rana
• Keywords: Echo (communications protocol); Functional mitral regurgitation

Functional mitral regurgitation (FMR) is a consequence of annular enlargement, leaflet tethering and reduced co-aptation. The importance the left atrium (LA) as cause (MR) less clear. We applied co-aptation index using three-dimensional (3D) transoesophageal echocardiography to FMR MR secondary LA dilatation (atrial regurgitation, AMR). Seventy-two patients underwent comprehensive 3D echo studies: (n = 19); AMR 33); 20 controls. recorded: LV size function; dimensions; area (MVA); in early late systole. MVA fractional change was defined: (MVA systole − systole)/MVA × 100%; (leaflet systole)/leaflet 100%. Despite normal function AMR, increased similarly (AMR 12.86 cm2 vs. 12.33 cm2, P ns; both < 0.01 controls 8.83 cm2), 5.1% 6.3%; 0.001 14.6%). groups (FMR 6.6% 7.0%, 19.6%). After multivariate analysis, (χ2 41.2) 22.1) remained strongest predictors (both for model). A ≤13% 96% sensitive 90% specific presence MR. leads even without dilatation. describes this vivo. This work provides insights into mechanism AMR.