Abstract 3371: 3D Quantitation of Mitral Valve Coaptation by Novel Software System with Transthoracic Real-time 3D Echocardiography
Background: In functional mitral regurgitation (FMR), restriction of leaflet closure due to papillary muscle displacement is thought to be a main mechanism. Degree of mitral valve (MV) leaflet coaptation should be an important parameter in the assessment of FMR. However, there have been no imaging modalities to evaluate the actual degree of coaptation, so that tenting area has been used as a substitute for the coaptation in the clinical setting. We sought to investigate the degree of MV coaptation with the use of a custom quantitation software system with transthoracic 3D echocardiography.
Methods and Results: Real-time 3D echocardiography was performed in 10 patients with dilated cardiomyopathy (DCM) and in 10 control subjects. 3D data were cropped into 18 radial planes, and we manually marked the annulus and traced the surface of MV tenting in early systole [E, the first moment of MV closure] and in late systole [L, the timing of maximum MV closure]. 3D image of MV apparatus was reconstructed for quantitative measurement and 3D tenting surface area was calculated. Coaptation ratio was calculated by the following fomula; (3D tenting surface area in E-L/E, Figure⇓). Coaptation ratio was 10±3.0% in patients with DCM and 24±5.0% in controls (p<0.05).
Conclusion: The custom quantitation software system with 3D echocardiography allows us to measure the actual degree of MV coaptation. Coaptation ratio in patients with DCM was significantly smaller than that in control subjects.