Mechanisms of functional mitral regurgitation in ischemic cardiomyopathy determined by transesophageal echocardiography (from the surgical treatment for ischemic heart failure trial)

Krzysztof Golba, Krzysztof Mokrzycki, Jaroslaw Drozdz, Alexander Cherniavsky, Krzysztof Wrobel, Bradley J. Roberts, Haissam Haddad, Gerald Maurer, Michael Yii, Federico M. Asch, Mark D. Handschumacher, Thomas A. Holly, Roman Przybylski, Irving Kron, Hartzell Schaff, Susan Aston, John Horton, Kerry L. Lee, Eric J. Velazquez, Paul A. Grayburn

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

The mechanisms underlying functional mitral regurgitation (MR) and the relation between mechanism and severity of MR have not been evaluated in a large, multicenter, randomized controlled trial. Transesophageal echocardiography (TEE) was performed in 215 patients at 17 centers in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Both 2-dimensional (n = 215) and 3-dimensional (n = 81) TEEs were used to assess multiple quantitative measurements of the mechanism and severity of MR. By 2-dimensional TEE, leaflet tenting area, anterior and posterior leaflet angles, mitral annulus diameter, left ventricular (LV) end-systolic volume index, LV ejection fraction (LVEF), and sphericity index (p <0.05 for all) were significantly different across MR grades. By 3-dimensional TEE, mitral annulus area, leaflet tenting area, LV end-systolic volume index, LVEF, and sphericity index (p <0.05 for all) were significantly different across MR grades. A multivariate analysis showed a trend for annulus area (p = 0.069) and LV end-systolic volume index (p = 0.071) to predict effective regurgitant orifice area and for annulus area (p = 0.018) and LV end-systolic volume index (p = 0.073) to predict vena contracta area. In the STICH trial, multiple quantitative parameters of the mechanism of functional MR are related to MR severity. The mechanism of functional MR in ischemic cardiomyopathy is heterogenous, but no single variable stands out as a strong predictor of quantitative severity of MR.

Original languageEnglish (US)
Pages (from-to)1812-1818
Number of pages7
JournalAmerican Journal of Cardiology
Volume112
Issue number11
DOIs
StatePublished - Dec 1 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Mechanisms of functional mitral regurgitation in ischemic cardiomyopathy determined by transesophageal echocardiography (from the surgical treatment for ischemic heart failure trial)'. Together they form a unique fingerprint.

  • Cite this

    Golba, K., Mokrzycki, K., Drozdz, J., Cherniavsky, A., Wrobel, K., Roberts, B. J., Haddad, H., Maurer, G., Yii, M., Asch, F. M., Handschumacher, M. D., Holly, T. A., Przybylski, R., Kron, I., Schaff, H., Aston, S., Horton, J., Lee, K. L., Velazquez, E. J., & Grayburn, P. A. (2013). Mechanisms of functional mitral regurgitation in ischemic cardiomyopathy determined by transesophageal echocardiography (from the surgical treatment for ischemic heart failure trial). American Journal of Cardiology, 112(11), 1812-1818. https://doi.org/10.1016/j.amjcard.2013.07.047