The Study On Mitral Valve Coaptation Index Of Rheumatic Patients By Real-time 3-dimensional Transesophageal Echocardiography

Objective This study aimed to investigate how to obtain the mitral valvecoaptation index(MVCI) in rheumatic patients using real-time 3-dimensionaltransesophageal echocardiography(RT-3D-TEE) and assess the clinicalsignificance of MVCI.Method 16 rheumatic patients with mitral regurgitation(MR) and 16 normalcontrols without mitral disease and MR were enrolled. (1)The real-time3-dimensional transesophageal echocardiography examinations were performed inall case. All 3-dimensional echocardiographic data were off-line analyzed usingmitral valve quantitatiion(MVQ) software.The mitral leaflets and annulus weretraced handly in the same phase. The mitral valve area(MVA), 3-dimensionalcircumference of mitral annulus(C3D) and 2-dimensional area of mitralannulus(A2D) of all cases were obtained in the end-systolic and early-diastolic.The MVCA and MVCI of all cases were calculated using the following formula:MVCA=MVAd-MVAs; MVCI=(MVCA/MVAd)×100%.(MVAd means MVA in diastolic phase, MVAs means MVA in systolic phase).(2)With the conventional echocardiography, the LVIDd, LVIDs, LA and LVEFwere measured in all cases, and the mitral regurgitation(MR) were measured inrheumatic patients.Result The MVCA and MVCI were successfully obtained in all cases. Comparedwith the normal controls, the MVCI was significantly smaller(P<0.001) inrheumatic patients. The MVCI was 10.4±2.8% in rheumatic patients and was 28.1±3.8%% in normal controls. The MVCI of anterior leaflet was smaller than theone of posterior leaflet in all cases(patients P=0.03, controls P=0.075). The MVA,LA, C3D and A2D in rheumatic patients were significantly bigger than those innormal controls(P<0.01).ConclusioConclusion The MVCI can be obtained using RT-3D-TEE and MVQ softwarewith high feasibility, the MVCI of rheumatic patients with MR is smaller than theone of normals. So the MVCI can be an morphology indicator for the quantitativeassessment on mitral valve cooperation in rheumatic patients.