Quantitative Evaluation Of Mitral Valve Geometry In Patients With Mitral Valve Prolapse By Real-time Three Dimensional Echocardiography

Objective By using MVA software and RT-3D-TTE,the valve leaflets and annulus of the mitral valve prolapse and normal control group were analyzed quantitatively,aims to explore the effect of mitral valve prolapse on the structure and function of the valve leaflets and annulus.so as to provide more valuable information for surgical program.Methods RT-3D TTE was performed in 30 normal controls(control group)and 30 patients with mitral valve prolapsed(MVP group).Various measurements of mitral valve leaflet and valve annulus were obrained using mitral valve assessment(MVA)software.The patients with mitral valvuloplasty in the prolapse group were collected and were followed up 9 months later.Results1.MVP group compared with the control group(1).Compared with the control group,the left ventricular end diastolic diameter and left atrial diameter of the in the patients with mitral valve prolapse were significantly increased(P<0.05).The Left ventricular ejection fraction of the prolapse group was not significantly different from that of the control group(P>0.05).(2).Annulus: The AP diameter,AL-PM diameter,annulus circumference(3D),annulus area(3D),annulus area(2D)and annulus height in the patients with mitral valve prolapse were larger than those in the controls(P<0.05).But there were no significance in sphericity index and non-planar angle between the two groups.(3).Leaflets: Commissural diameter,anterior leaflet area,posterior leaflet area,anterior leaflet length and posterior leaflet length in the patients with mitral valve prolapse were larger than those in the controls(P<0.05).Posterior leaflet angle in the patients with mitral valve prolapse was smaller than those in the controls(P<0.05).But there were no significance in tenting height,tenting volume and tenting area between the two groups.(4).Misc and dynamic: Angle AAO-AP in the patients with mitral valve prolapse was smaller than those in the controls(P<0.05).But there were no significance in annular displacement(max),annular displacement velocity(max)and annular area fraction(2D)between the two groups.2.Postoperation group compared with the preoperative group with MVP(1).Left ventricular diameter in postoperation group is significantly decreased compared with preoperative,the difference was statistically significant(P<0.05).Compared with the preoperative left atrial diameter and EF prolapse patients after surgery,there was no statistically significant difference(P>0.05).(2).Annulus: The AP diameter,AL-PM diameter,annulus circumference(3D),annulus area(3D),annulus area(2D)and annulus height in postoperation group were smaller than those in the preoperative group(P<0.05).But sphericity index and non-planar angle were larger than those in the preoperative group(P<0.05).(3).Leaflets: Commissural diameter,anterior leaflet area,posterior leaflet area,tenting volume and tenting area in postoperation group were smaller than those in the preoperative group(P<0.05).But there were no significance in tenting height,anterior leaflet length,posterior leaflet length and posterior leaflet angle between the two groups.(4).Misc and dynamic: Angle AAO-AP and annular area fraction(2D)in postoperation group were larger than those in the preoperative group(P<0.05).Annular displacement(max)and annular displacement velocity(max)in postoperation group were smaller than those in the preoperative group(P<0.05).Conclusion 1.Mitral valve prolapse can result in the change of the geometric structure of the valve annulus and the valve leaflets,while maintaining the non planar characteristics of the valve ring,but it has little effect on the dynamic deformation and the contractile function of the annulus.2.Mitral valvuloplasty can improve the geometric structure of mitral valve prolapse,which is beneficial to the reduction of mitral valve annulu and the involution of the leaflet.,and can effectively improve the hemodynamic changes caused by prolapse.3.Real time three-dimensional transthoracic echocardiography combined with MVA software can quickly and effectively evaluate the geometric structure of mitral valve,which can precisely describe the changes of the morphology and structure of the mitral valve annulus and leaflets.And it has important clinical value and broad application prospects in the study of mitral regurgitation,clinical diagnosis and treatment.