Dynamism of the Mitral Annulus: A Spatial and Temporal Analysis
Objective In this study, the authors sought to investigate the extent and timing of changes in mitral annular area during the cardiac cycle. Particularly, the authors assessed whether these changes were limited to the posterior part of the annulus or were more global in nature. Design Prospective, o...
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| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 2014-10, Vol.28 (5), p.1191-1197 |
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| creator | Jiang, Luyang, MD Owais, Khurram, MD Matyal, Robina, MD Khabbaz, Kamal R., MD Liu, David C., MD Montealegre-Gallegos, Mario, MD Hess, Philip E., MD Mahmood, Feroze, MD |
| description | Objective In this study, the authors sought to investigate the extent and timing of changes in mitral annular area during the cardiac cycle. Particularly, the authors assessed whether these changes were limited to the posterior part of the annulus or were more global in nature. Design Prospective, observational study Setting Tertiary care university hospital Participants Twenty three patients undergoing non-valvular cardiac surgery and 3 patients undergoing vascular procedures. Interventions Intraoperative 3-dimensional transesophageal echocardiographic data obtained from patients with normal mitral valves undergoing non-valvular cardiac surgery were analyzed geometrically. Annular areas and diameters were measured during various stages of the cardiac cycle. Intertrigonal distance also was measured using 3D data. Measurements and Main Results Both anterior and posterior portions of the mitral annulus demonstrated dynamism throughout the cardiac cycle. The expansion phase ranged from mid-systole to early-diastole, whereas mid-diastole to early-systole was characterized by an annular contraction phase. Area changes were contributed equally by anterior and posterior parts of the annulus. Annular dimensions increased in accordance with mitral annular area (p |
| doi_str_mv | 10.1053/j.jvca.2014.03.020 |
| format | Article |
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Particularly, the authors assessed whether these changes were limited to the posterior part of the annulus or were more global in nature. Design Prospective, observational study Setting Tertiary care university hospital Participants Twenty three patients undergoing non-valvular cardiac surgery and 3 patients undergoing vascular procedures. Interventions Intraoperative 3-dimensional transesophageal echocardiographic data obtained from patients with normal mitral valves undergoing non-valvular cardiac surgery were analyzed geometrically. Annular areas and diameters were measured during various stages of the cardiac cycle. Intertrigonal distance also was measured using 3D data. Measurements and Main Results Both anterior and posterior portions of the mitral annulus demonstrated dynamism throughout the cardiac cycle. The expansion phase ranged from mid-systole to early-diastole, whereas mid-diastole to early-systole was characterized by an annular contraction phase. Area changes were contributed equally by anterior and posterior parts of the annulus. Annular dimensions increased in accordance with mitral annular area (p<0.05). Echocardiographically-identified intertrigonal distance showed the least delta change. Conclusions Both the anterior and posterior parts of the annulus contribute to changes in mitral annular area, which undergoes discrete expansion and contraction phases that extend into both systole and diastole. Compared to other annular dimensions, the echocardiographically-identified intertrigonal distance does not change significantly during the cardiac cycle.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2014.03.020</identifier><identifier>PMID: 25130425</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Anesthesia & Perioperative Care ; cardiac surgery ; Cardiac Surgical Procedures ; Critical Care ; Echocardiography, Three-Dimensional - methods ; Elective Surgical Procedures ; Female ; Hemodynamics - physiology ; Humans ; Male ; Middle Aged ; mitral valve ; Mitral Valve - diagnostic imaging ; Mitral Valve - physiology ; mitral valve annulus ; Prospective Studies ; Time Factors ; transesophageal echocardiography</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2014-10, Vol.28 (5), p.1191-1197</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-9cce8cdad3e81e6e86eb470e3baf74d12b9ee254dd38526eee0b876a5dc063ce3</citedby><cites>FETCH-LOGICAL-c481t-9cce8cdad3e81e6e86eb470e3baf74d12b9ee254dd38526eee0b876a5dc063ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.jvca.2014.03.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25130425$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiang, Luyang, MD</creatorcontrib><creatorcontrib>Owais, Khurram, MD</creatorcontrib><creatorcontrib>Matyal, Robina, MD</creatorcontrib><creatorcontrib>Khabbaz, Kamal R., MD</creatorcontrib><creatorcontrib>Liu, David C., MD</creatorcontrib><creatorcontrib>Montealegre-Gallegos, Mario, MD</creatorcontrib><creatorcontrib>Hess, Philip E., MD</creatorcontrib><creatorcontrib>Mahmood, Feroze, MD</creatorcontrib><title>Dynamism of the Mitral Annulus: A Spatial and Temporal Analysis</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>Objective In this study, the authors sought to investigate the extent and timing of changes in mitral annular area during the cardiac cycle. Particularly, the authors assessed whether these changes were limited to the posterior part of the annulus or were more global in nature. Design Prospective, observational study Setting Tertiary care university hospital Participants Twenty three patients undergoing non-valvular cardiac surgery and 3 patients undergoing vascular procedures. Interventions Intraoperative 3-dimensional transesophageal echocardiographic data obtained from patients with normal mitral valves undergoing non-valvular cardiac surgery were analyzed geometrically. Annular areas and diameters were measured during various stages of the cardiac cycle. Intertrigonal distance also was measured using 3D data. Measurements and Main Results Both anterior and posterior portions of the mitral annulus demonstrated dynamism throughout the cardiac cycle. The expansion phase ranged from mid-systole to early-diastole, whereas mid-diastole to early-systole was characterized by an annular contraction phase. Area changes were contributed equally by anterior and posterior parts of the annulus. Annular dimensions increased in accordance with mitral annular area (p<0.05). Echocardiographically-identified intertrigonal distance showed the least delta change. Conclusions Both the anterior and posterior parts of the annulus contribute to changes in mitral annular area, which undergoes discrete expansion and contraction phases that extend into both systole and diastole. Compared to other annular dimensions, the echocardiographically-identified intertrigonal distance does not change significantly during the cardiac cycle.</description><subject>Aged</subject><subject>Anesthesia & Perioperative Care</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures</subject><subject>Critical Care</subject><subject>Echocardiography, Three-Dimensional - methods</subject><subject>Elective Surgical Procedures</subject><subject>Female</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mitral valve</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - physiology</subject><subject>mitral valve annulus</subject><subject>Prospective Studies</subject><subject>Time Factors</subject><subject>transesophageal echocardiography</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1P3DAQhq2qqLul_QM9VDn2kjC248RBFWhF-ZJAHNieLceeVR3ysdgJ0v57HO2WAwdOY43f99XMM4T8oJBREPykyZoXozMGNM-AZ8DgE1lSwVkqc8Y-x3dUpVCWsCBfQ2gAKBWi_EIWTFAOORNLcv5n1-vOhS4ZNsn4D5N7N3rdJqu-n9opnCar5HGrRxdburfJGrvtsP_X7S648I0cbXQb8PuhHpO_V5fri5v07uH69mJ1l5pc0jGtjEFprLYcJcUCZYF1XgLyWm_K3FJWV4hM5NZyKViBiFDLstDCGii4QX5Mfu1zt354njCMKg5tsG11j8MUFBWyoEChqqKU7aXGDyF43Kitd532O0VBzUhUo2ZwagangKsILpp-HvKnukP7ZvlPKgp-7wUYt3xx6FUwDnuD1nk0o7KD-zj_7J3dtK53RrdPuMPQDJOPROMeKjAF6nHOmS9H8_lqsuKvLPKTIA</recordid><startdate>20141001</startdate><enddate>20141001</enddate><creator>Jiang, Luyang, MD</creator><creator>Owais, Khurram, MD</creator><creator>Matyal, Robina, MD</creator><creator>Khabbaz, Kamal R., MD</creator><creator>Liu, David C., MD</creator><creator>Montealegre-Gallegos, Mario, MD</creator><creator>Hess, Philip E., MD</creator><creator>Mahmood, Feroze, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141001</creationdate><title>Dynamism of the Mitral Annulus: A Spatial and Temporal Analysis</title><author>Jiang, Luyang, MD ; Owais, Khurram, MD ; Matyal, Robina, MD ; Khabbaz, Kamal R., MD ; Liu, David C., MD ; Montealegre-Gallegos, Mario, MD ; Hess, Philip E., MD ; Mahmood, Feroze, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-9cce8cdad3e81e6e86eb470e3baf74d12b9ee254dd38526eee0b876a5dc063ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Anesthesia & Perioperative Care</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures</topic><topic>Critical Care</topic><topic>Echocardiography, Three-Dimensional - methods</topic><topic>Elective Surgical Procedures</topic><topic>Female</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mitral valve</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - physiology</topic><topic>mitral valve annulus</topic><topic>Prospective Studies</topic><topic>Time Factors</topic><topic>transesophageal echocardiography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jiang, Luyang, MD</creatorcontrib><creatorcontrib>Owais, Khurram, MD</creatorcontrib><creatorcontrib>Matyal, Robina, MD</creatorcontrib><creatorcontrib>Khabbaz, Kamal R., MD</creatorcontrib><creatorcontrib>Liu, David C., MD</creatorcontrib><creatorcontrib>Montealegre-Gallegos, Mario, MD</creatorcontrib><creatorcontrib>Hess, Philip E., MD</creatorcontrib><creatorcontrib>Mahmood, Feroze, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jiang, Luyang, MD</au><au>Owais, Khurram, MD</au><au>Matyal, Robina, MD</au><au>Khabbaz, Kamal R., MD</au><au>Liu, David C., MD</au><au>Montealegre-Gallegos, Mario, MD</au><au>Hess, Philip E., MD</au><au>Mahmood, Feroze, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dynamism of the Mitral Annulus: A Spatial and Temporal Analysis</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2014-10-01</date><risdate>2014</risdate><volume>28</volume><issue>5</issue><spage>1191</spage><epage>1197</epage><pages>1191-1197</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Objective In this study, the authors sought to investigate the extent and timing of changes in mitral annular area during the cardiac cycle. Particularly, the authors assessed whether these changes were limited to the posterior part of the annulus or were more global in nature. Design Prospective, observational study Setting Tertiary care university hospital Participants Twenty three patients undergoing non-valvular cardiac surgery and 3 patients undergoing vascular procedures. Interventions Intraoperative 3-dimensional transesophageal echocardiographic data obtained from patients with normal mitral valves undergoing non-valvular cardiac surgery were analyzed geometrically. Annular areas and diameters were measured during various stages of the cardiac cycle. Intertrigonal distance also was measured using 3D data. Measurements and Main Results Both anterior and posterior portions of the mitral annulus demonstrated dynamism throughout the cardiac cycle. The expansion phase ranged from mid-systole to early-diastole, whereas mid-diastole to early-systole was characterized by an annular contraction phase. Area changes were contributed equally by anterior and posterior parts of the annulus. Annular dimensions increased in accordance with mitral annular area (p<0.05). Echocardiographically-identified intertrigonal distance showed the least delta change. Conclusions Both the anterior and posterior parts of the annulus contribute to changes in mitral annular area, which undergoes discrete expansion and contraction phases that extend into both systole and diastole. Compared to other annular dimensions, the echocardiographically-identified intertrigonal distance does not change significantly during the cardiac cycle.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25130425</pmid><doi>10.1053/j.jvca.2014.03.020</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Anesthesia & Perioperative Care cardiac surgery Cardiac Surgical Procedures Critical Care Echocardiography, Three-Dimensional - methods Elective Surgical Procedures Female Hemodynamics - physiology Humans Male Middle Aged mitral valve Mitral Valve - diagnostic imaging Mitral Valve - physiology mitral valve annulus Prospective Studies Time Factors transesophageal echocardiography |
| title | Dynamism of the Mitral Annulus: A Spatial and Temporal Analysis |
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