Dinámica del anillo mitral en pacientes con insuficiencia mitral isquemica
Jaimes Castellanos, Claudia Patricia
OBJECTIVES: To describe and compare the dynamic changes in the geometry of the mitral ring in patients with ischemic mitral regurgitation and normal mitral valve. MATERIALS AND METHODS: 37 studies were analyzed, 23 with ischemic mitral regurgitation and 14 without mitral regurgitation. The mitral ring reconstruction was performed in Xcelera workstation (Philips Medial Systems, Andover, Massachusetts) with a mitral analysis tool (MVQ), in 5 different times of the cardiac cycle: Early systole, middle systole, late systole, middle diastolic and late diastole. RESULTS: The mitral ring of the control group, was more dynamic, with its smaller size in the late diastole, with a progressive increase during systole. Changes in the perimeter and area were significant between the early and middle of systole (p: 0.087 and p: 0.055, respectively). In the group with ischemic mitral regurgitation, the ring was more static. All dimensions were larger in this group, with a significant difference in every dimension (p <0.1). The annular morphological index was lower is this group, than in the control group. DISCUSSION AND CONCLUSIONS: The mitral ring is a dynamic structure in patients without mitral regurgitation. During systole, the smaller dimensions occurred at the beginning of this period and the saddle shape remained during the whole cardiac cycle, protecting against mitral regurgitation. The mitral ring was static and flat in patients with ischemic mitral regurgitation, losing the protective mechanisms described in the control group.
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