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FIBROELASTIC DEFICIENCY VERSUS BARLOW'S DISEASE: DIFFERENCES IN MITRAL ANNULAR DYNAMICS BY 3-DIMENSIONAL ECHOCARDIOGRAPHY
A1985 JACC April 1, 2014 Volume 63, Issue 12
Valvular Heart Disease Fibroelastic Deficiency versus Barlow’s Disease: Differences in Mitral Annular Dynamics by 3-Dimensional Echocardiography Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Valvular Heart Disease: Functional Imaging Abstract Category: 28. Valvular Heart Disease: Clinical Presentation Number: 1195-345 Authors: Marie-Annick Clavel, Francesca Mantovani, Ori Vatury, Rakesh Suri, Sunil Mankad, Maurice Sarano, Mayo Clinic, Rochester, MN, USA Background: Fibroelastic deficiency (FED) and Barlow’s disease (BaD) are a spectrum of degenerative mitral valve (DMV) disease. We aimed to determine differences in annular dimensions and dynamics between FED and BaD. Methods: We measured annular dimensions by real-time 3D TEE in 49 patients with DMV and severe regurgitation prior to MV surgery. According to surgical observation, patients were classified in 2 groups as FED or BaD. Results: FED (32) and BaD (18) patients had similar age (65±10 vs. 59±13, p=0.5), body surface area (2.0±0.2 vs. 2.0±0.2 m2, p=0.5) and LV Ejection Fraction (63±7vs. 63±8%, p=0.9). Annular area and intercommissural diameter were smaller and mostly stable during the whole cardiac cycle in FED patients while larger and increasing during systole in BaD patients (all p<0.001) (Figure). Anteroposterior diameter was smaller in FED than BaD (p<0.001) but with similar motion (p=0.16). Height was similar between groups in term of dimension (p=0.76) and dynamics (p=0.71). In term of general dynamic, saddle shape progressively increases from diastole to systole in FED (p<0.03) patients while it remains stable in BaD patients (p>0.53) (Figure). Conclusion: FED and BaD disease show different annular geometry and dynamics with larger dimensions and loss of saddle shape deepening throughout cardiac circle in BaD disease. These findings may have implication in surgical restoration of mitral annular shape and repair durability.
Valvular Heart Disease Fibroelastic Deficiency versus Barlow’s Disease: Differences in Mitral Annular Dynamics by 3-Dimensional Echocardiography Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Valvular Heart Disease: Functional Imaging Abstract Category: 28. Valvular Heart Disease: Clinical Presentation Number: 1195-345 Authors: Marie-Annick Clavel, Francesca Mantovani, Ori Vatury, Rakesh Suri, Sunil Mankad, Maurice Sarano, Mayo Clinic, Rochester, MN, USA Background: Fibroelastic deficiency (FED) and Barlow’s disease (BaD) are a spectrum of degenerative mitral valve (DMV) disease. We aimed to determine differences in annular dimensions and dynamics between FED and BaD. Methods: We measured annular dimensions by real-time 3D TEE in 49 patients with DMV and severe regurgitation prior to MV surgery. According to surgical observation, patients were classified in 2 groups as FED or BaD. Results: FED (32) and BaD (18) patients had similar age (65±10 vs. 59±13, p=0.5), body surface area (2.0±0.2 vs. 2.0±0.2 m2, p=0.5) and LV Ejection Fraction (63±7vs. 63±8%, p=0.9). Annular area and intercommissural diameter were smaller and mostly stable during the whole cardiac cycle in FED patients while larger and increasing during systole in BaD patients (all p<0.001) (Figure). Anteroposterior diameter was smaller in FED than BaD (p<0.001) but with similar motion (p=0.16). Height was similar between groups in term of dimension (p=0.76) and dynamics (p=0.71). In term of general dynamic, saddle shape progressively increases from diastole to systole in FED (p<0.03) patients while it remains stable in BaD patients (p>0.53) (Figure). Conclusion: FED and BaD disease show different annular geometry and dynamics with larger dimensions and loss of saddle shape deepening throughout cardiac circle in BaD disease. These findings may have implication in surgical restoration of mitral annular shape and repair durability.