Abstract
Many hypotheses regarding the mechanism of secondary mitral regurgitation (SMR) have been made from 2D echocardiographic observations. Some have been confirmed and further developed with the help of 3D echocardiography (Otsuji et al., Circulation 96:1999–2008; Otsuji et al., J Am Coll Cardiol 37:641–8, 2001). 3D echocardiography, and especially 3D transesophageal echocardiography (TEE), has much to offer in the evaluation of SMR, in addition to 2D echocardiography. First, it offers important information regarding MV geometry, giving insights into the mechanisms involved in the genesis of SMR in each patient. Second, it can improve the accuracy of MR quantification (Chandra et al., Am J Physiol Heart Circ Physiol 301:H1015–24, 2011; Hyodo et al., J Am Coll Cardiol Img 5:669–76, 2012). Third, it can play an important role in the planning of surgery or percutaneous intervention.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Otsuji Y, Handschumacher M, Schwammenthal E, et al. Insights from three dimensional echocardiography into the mechanism of functional mitral regurgitation. Circulation. 1997;96:1999–2008.
Otsuji Y, Hanschumacher MD, Liel-Cohen N, et al. Mechanism of ischemic mitral regurgitation with segmental left ventricular dysfunction: three-dimensional echocardiographic studies in models of acute and chronic progressive regurgitation. J Am Coll Cardiol. 2001;37:641–8.
Chandra S, Salgo I, Sugeng L, et al. A three-dimensional insight into the complexity of flow convergence in mitral regurgitation: adjunctive benefit of anatomic regurgitant orifice area. Am J Physiol Heart Circ Physiol. 2011;301:H1015–24.
Hyodo E, Iwata S, Tugcu A, et al. Direct measurement of multiple vena contracta areas for assessing the severity of mitral regurgitation using 3D TEE. J Am Coll Cardiol Img. 2012;5:669–76.
Watanabe N, Ogasawara Y, Yamaura Y, et al. Geometric deformity of the mitral annulus in patients with ischemic mitral regurgitation: a real-time three-dimensional echocardiographic study. J Heart Valve Dis. 2005;14:447–52.
Ahmad RM, Gillinov AM, McCarthy PM, et al. Annular geometry and motion in human ischemic mitral regurgitation: novel assessment with three-dimensional echocardiography and computer reconstruction. Ann Thorac Surg. 2004;78:2063–8.
Watanabe N, Ogasawara Y, Yamaura Y, et al. Mitral annulus flattens in ischemic mitral regurgitation: geometric differences between inferior and anterior myocardial infarction. A real-time 3-dimensional echocardiographic study. Circulation. 2005;112:I-458–62.
Daimon M, Gillinov AM, Liddicoat JR, et al. Dynamic change in mitral annular area and motion during percutaneous mitral annuloplasty for ischemic mitral regurgitation: preliminary animal study with real-time 3-dimensional echocardiography. J Am Soc Echocardiogr. 2007;20:381–8.
Flachskampf F, Chandra S, Gaddipatti A, et al. Analysis of shape and motion of the mitral annulus in subjects with and without cardiomyopathy by echocardiographic 3-dimensional reconstruction. J Am Soc Echocardiogr. 2000;13:277–87.
Chaput M, Handschumacher MD, Guerrero J, et al. Mitral leaflet adaptation to ventricular remodeling: prospective changes in a model of ischemic mitral regurgitation. Circulation. 2009;120(11 Suppl):S99–103.
Saito K, Okura H, Watanabe N, et al. Influence of chronic tethering of the mitral valve on mitral leaflet size and coaptation in functional mitral regurgitation. J Am Coll Cardiol Img. 2012;5(4):337–45.
Chen L, McCulloch A, May-Newman K. Nonhomogeneous deformation in the anterior leaflet of the mitral valve. Ann Biomed Eng. 2004;32:1599–606.
Otsuji Y, Kumanohoso T, Yoshifuku S, et al. Isolated annular dilation does not usually cause important functional mitral regurgitation: comparison between patients with lone atrial fibrillation and those with idiopathic or ischemic cardiomyopathy. J Am Coll Cardiol. 2002;39(10):1651–6.
Lancellotti P, Moura L, Pierard LA, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr. 2010;11:307–32.
Marsan N, Westenberg J, Ypenburg C, et al. Quantification of functional mitral regurgitation by real-time 3D echocardiography: comparison with 3D velocity-encoded cardiac magnetic resonance. J Am Coll Cardiol Img. 2009;2(11):1245–52.
Yosefy C, Hung J, Chua S, et al. Direct measurement of vena contracta area by real-time 3-dimensional echocardiography for assessing severity of mitral regurgitation. Am J Cardiol. 2009;104(7):978–83.
Thavendiranathan P, Phelan D, Thomas J, et al. Quantitative assessment of mitral regurgitation: validation of new methods. J Am Coll Cardiol. 2012;60:1470–83.
Matsumura Y, Fukuda S, Tran H, et al. Geometry of the proximal isovelocity surface area in mitral regurgitation by 3-dimensional color Doppler echocardiography: difference between functional mitral regurgitation and prolapse regurgitation. Am Heart J. 2008;155:231–8.
Grady L, Datta S, Kutter O, et al. Regurgitation quantification using 3D PISA in volume echocardiography. Med Image Comput Comput Assist Interv. 2011;14(Pt 3):512–9.
Thavendiranathan P, Liu S, Datta S, et al. Quantification of chronic functional mitral regurgitation by automated 3-dimensional peak and integrated proximal isovelocity surface area and stroke volume techniques using real-time 3-dimensional volume color Doppler echocardiography: in vitro and clinical validation. Circ Cardiovasc Imaging. 2013;6:125–33.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
3D Zoom mode acquisition of the mitral valve as seen from the atrial perspective (“surgeon’s view) by 3D transoesophageal echocardiography. The displayed image is then rotated in such a way that the aorta is located anteriorly. (AVI 5579 kb)
3D Zoom mode acquisition of the mitral valve as seen from the ventricular perspective by 3D transoesophageal echocardiography. The displayed image is then rotated in such a way that the anterior mitral leaflet is seen opening in diastole towards the interventricular septum, while the posterior leaflet is almost fixed during the cardiac cycle. (AVI 3927 kb)
313059_1_En_5_MOESM3_ESM.avi
Full Volume Color Flow Doppler Gated Acquisition with 3D transoesophageal echocardiography in a patient with ischemic mitral regurgitation and a centrally oriented regurgitation jet, indicative of symmetric tethering pattern. (AVI 3628 kb)
Movie 5.3
Full Volume Color Flow Doppler Gated Acquisition with 3D transoesophageal echocardiography in a patient with ischemic mitral regurgitation and a centrally oriented regurgitation jet, indicative of symmetric tethering pattern. (AVI 3628 kb)
Rights and permissions
Copyright information
© 2015 Springer-Verlag London
About this chapter
Cite this chapter
Dulgheru, R., Thavendiranathan, P., Fattouch, K., Vannan, M., Lancellotti, P. (2015). Three-Dimensional Echocardiographic Imaging of Secondary Mitral Valve Regurgitation. In: Fattouch, K., Lancellotti, P., Angelini, G. (eds) Secondary Mitral Valve Regurgitation. Springer, London. https://doi.org/10.1007/978-1-4471-6488-3_5
Download citation
DOI: https://doi.org/10.1007/978-1-4471-6488-3_5
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6487-6
Online ISBN: 978-1-4471-6488-3
eBook Packages: MedicineMedicine (R0)