Ischemic Mitral Regurgitation: Impact of the Left Ventricle and Mitral Valve in Patients with Left Ventricular Systolic Dysfunction Monvadi B. Srichai,

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Presentation transcript:

Ischemic Mitral Regurgitation: Impact of the Left Ventricle and Mitral Valve in Patients with Left Ventricular Systolic Dysfunction Monvadi B. Srichai, MD, Richard A. Grimm, DO, Arthur E. Stillman, MD, PhD, A. Marc Gillinov, MD, L. Leonardo Rodriguez, MD, Michael L. Lieber, MS, Abigail Lara, MD, Joan A. Weaver, RT, (R)MR, Patrick M. McCarthy, MD, Richard D. White, MD The Annals of Thoracic Surgery Volume 80, Issue 1, Pages 170-178 (July 2005) DOI: 10.1016/j.athoracsur.2005.01.068 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Flow chart demonstrating patient selection of mitral regurgitation (MR) severity groups. *Patients with structural valvular abnormalities were excluded. (Echo = echocardiography; LVEF = left ventricular ejection fraction; MRI = magnetic resonance imaging.) The Annals of Thoracic Surgery 2005 80, 170-178DOI: (10.1016/j.athoracsur.2005.01.068) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Cine magnetic resonance imaging three-chamber view demonstrating the measurement of annulus diameter and coaptation height (left), and mitral tenting area (right) of the mitral valve apparatus. The Annals of Thoracic Surgery 2005 80, 170-178DOI: (10.1016/j.athoracsur.2005.01.068) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Scatter plot graphs of average wall motion score for the entire ventricle (top), anterior-lateral (middle), and inferior-posterior region (bottom) for each mitral regurgitation (MR) severity group. (Mod = moderate; NS = not significant.) The Annals of Thoracic Surgery 2005 80, 170-178DOI: (10.1016/j.athoracsur.2005.01.068) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Scatter plot graphs of average myocardial scar grade for the entire ventricle (top), anterior-lateral (middle) and inferior-posterior region (bottom) for each mitral regurgitation (MR) severity group. (Mod = moderate.) The Annals of Thoracic Surgery 2005 80, 170-178DOI: (10.1016/j.athoracsur.2005.01.068) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Transthoracic color-Doppler Echo images in the 2-chamber (A), 3-chamber (B) and 4-chamber (C) views demonstrating severe mitral regurgitation. Delayed-enhancement magnetic resonance images in the 2-chamber (D), 3-chamber (E), and 4-chamber (F) long-axis views as well as basal (G), middle (H) and apical (I) short-axis views demonstrating severe myocardial scarring localized to the inferior-posterior region as seen by the hyper-enhanced areas (arrows). The Annals of Thoracic Surgery 2005 80, 170-178DOI: (10.1016/j.athoracsur.2005.01.068) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Transthoracic color-Doppler Echo images in the 2-chamber (A), 3-chamber (B) and 4-chamber (C) views demonstrating severe mitral regurgitation. Delayed-enhancement magnetic resonance images in the 2-chamber (D), 3-chamber (E), and 4-chamber (F) long-axis views as well as basal (G), middle (H) and apical (I) short-axis views demonstrating moderate-severe myocardial scarring localized to the anterior-lateral region as seen by the hyper-enhanced areas (arrows). The Annals of Thoracic Surgery 2005 80, 170-178DOI: (10.1016/j.athoracsur.2005.01.068) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions