Abstract
The aim of the study was to make a assessment of the geometric and functional parameters of the left ventricular- mitral valve complex in patients with coronary heart disease (CHD) with various types of ischemic mitral regurgitation (MR) using the method of Doppler tissue imaging.
Material and methods. The study included 99 patients with CHD. Patients were divided into 3 groups: 1 group (20 patients) with an asymmetric jet of MR (along the posterior-medial commissure); 2 group (39 patients) with a central jet of MP; Group 3 (40 patients with CHD) with MR ≤1 degree.
Results. Тhe formation of an asymmetric jet of ischemic MR is characterized by: 1) the presence of remodeling of the posterior, posterior-lower and posterior-lateral segments of the left ventricle (LV) with an increase in the sphericity indices at the basal and middle levels, a moderate increase in the total end diastolic volume LV; 2) disturbances in the geometry of the mitral valve apparatus: an increase in the interpapillary distance, coaptation distance, tenting area, an increase in the angle between the posterior mitral leaflet (PML) and the fibrous ring of the mitral valve, indicating a displacement of the posterior papillary muscle back, tethering chords to posterior mitral leaflet and restriction of PML, displacement of coaptation point posteriorly. The formation of the central jet of ischemic MR is characterized by: 1) severe violations of geometric parameters and contractile function of the LV, more pronounced dilatation of the LV, an increase in sphericity indices at all levels; more severe degree of MR; 3) severe disturbances in the geometry of the mitral valve apparatus: an increase in the interpapillary distance, coaptation distance, tenting area, more pronounced dilatation of the valve fibrous ring, a decrease in the angle of coaptation between the anterior mitral leaflet and PML, which indicates the displacement of both papillary muscles apically.
Conclusion. The pathogenesis of the formation of two types of ischemic MR is different.
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About the authors
- Buziashvili Yuriy Iosifovich, Dr. Med. Sc., Professor, Academician of the Russian Academy of Sciences, Head of the Clinico-Diagnostic Department;
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Koksheneva Inna Valerievna, Dr. Med. Sc., Senior Researcher; orcid.org/0000-0002-8797-9340
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Asymbekova El’mira Umetovna, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0002-5422-2069
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Turakhonov Timur Kurbanalievich, Postgraduate;
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Abukov Said Temishevich, Сardiologist;
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Sherstyannikova Ol’ga Mikhaylovna, Cand. Med. Sc., Researcher; orcid.org/0000-0002-0340-695X
