Title: The echocardiographic determinants of functional mitral regurgitation differ in ischemic and non-ischemic cardiomyopathy
Abstract: <h2>Abstract</h2><h3>Background</h3> Functional mitral regurgitation (MR) is one of the common and severe complications in patients with dilated cardiomyopathy. The detailed mechanisms that cause functional MR remain to be elucidated. Using two-dimensional transthoracic echocardiography, we investigated the differences in major determinants of MR severity between ischemic cardiomyopathy (ICM) and non-ICM patients. <h3>Methods</h3> We enrolled 103 patients (91 males; age 64±12 years) with significant left ventricular (LV) dilatation. They were divided into ICM group (<i>n</i>=69) with significant coronary disease, and non-ICM (<i>n</i>=34) group without coronary disease. We devised a novel and simple parameter; the short-axis sphericity index (SI), to evaluate global LV remodeling, and used coaptation depth (CD) and tenting area (TA) to evaluate mitral deformity. <h3>Results</h3> In all cases, CD, TA and left atrium diameter (LAD) correlated positively with maximum regurgitation area (MRA) (<i>r</i>=0.54, 0.57, 0.57; <i>P</i><0.0001). A negative correlation was observed between MRA and SI (<i>r</i>=−0.33, <i>P</i>=0.0008). There was no significant relationship between MRA and LV ejection fraction (EF). In non-ICM cases, SI tended to be lower with reduced EF. Multivariate stepwise linear regression analysis showed the following equations; ICM: MRA=−9.4+0.81CD+0.21LAD (<i>r</i><sup>2</sup>=0.47, <i>P</i><0.0001), non-ICM: MRA=−7.2+0.17LVDs (LV end systolic diameter) −8.7SI+0.27LAD (<i>r</i><sup>2</sup>=0.63, <i>P</i><0.0001). <h3>Conclusions</h3> The strongest determinants of functional MR severity differ in ICM and non-ICM. While LV diameter and SI (global LV remodeling index) mainly determine the severity in non-ICM, CD that reflects mitral deformity is the major determinant in ICM.
Publication Year: 2005
Publication Date: 2005-05-25
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 54
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