Abstract 12741: Atrial Fibrillation Flattens Annular Saddle Shape of Mitral Valve and Dilates Mitral Annulus
Introduction: Normal mitral annulus has a saddle shape. The saddle shape of annulus may provide a configuration more capable of withstanding the stresses imposed by left ventricular pressure. Meanwhile, atrial fibrillation (AF) induces atrial contractile dysfunction, stretch of the atrial myocardium, and mitral regurgitation. Although the advances of real-time 3-dimentional transesophageal echocardiography enabled the quantitative morphological analysis of the mitral valve, the impact of AF on mitral valve remains unclear.
Hypothesis: We assessed the hypothesis that AF might flatten the annular saddle shape of mitral valve and dilate mitral annulus.
Methods: We performed real-time 3-dimentional transesophageal echocardiography of the mitral valve in 82 consecutive patients between April 2013 and March 2014. The quantitative morphological analysis on the mitral valve was the performed with custom software. Exclusion criteria in advance included dilated left ventricule, cardiomyopathy, structural abnormality of any the valves including valvular stenosis and mitral valve prolapse, history of cardiac surgery, and congenital or pericardial heart disease.
Results: AF was present in 48 (58.5%) patients of enrolled patients. Comparisons of mitral valve geometry between AF and sinus rhythm (SR) group are summarized in Table. Compared with SR group, AF group had more dilated mitral annulus, reduced annular height, and a reduced annular height to commissural width ratio (AHCWR) indicating flattening of annular saddle shape. Mitral regurgitation severity inversely correlated with AHCWR (r = -0.36, p = 0.001).
Conclusions: AF was significantly associated with flattening of the mitral annular saddle shape and dilated mitral annulus. Thus AF might lead to structural atrial remodeling and deterioration of mitral regurgitation.
Author Disclosures: Y. Uchida: None. S. Ichimiya: None. H. Oishi: None. T. Aoki: None. Y. Miki: None. T. Kawamiya: None. H. Ichimiya: None. J. Watanabe: None. M. Kanashiro: None. H. Ishii: None. T. Amano: None. T. Matsubara: None. T. Murohara: None.
- © 2014 by American Heart Association, Inc.