Geometric Changes in Mitral Valve Apparatus during Long-term Cardiac Resynchronization Therapy as Assessed with Cardiac CT.

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-10-01 DOI:10.1148/ryct.230320
Daniel B Fyenbo, Bjarne L Nørgaard, Philipp Blanke, Anders Sommer, Jade Duchscherer, Kelsey Kalk, Mads B Kronborg, Jesper M Jensen, Elliot R McVeigh, Victoria Delgado, Jonathon Leipsic, Jens C Nielsen
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Abstract

Purpose To assess long-term geometric changes of the mitral valve apparatus using cardiac CT in individuals who underwent cardiac resynchronization therapy (CRT). Materials and Methods Participants from a randomized controlled trial with cardiac CT examinations before CRT implantation and at 6 months follow-up (Clinicaltrials.gov identifier NCT01323686) were invited to undergo an additional long-term follow-up cardiac CT examination. The geometry of the mitral valve apparatus, including mitral valve annulus area, A2 leaflet angle, tenting height, and interpapillary muscle distances, were assessed. Geometric changes at the long-term follow-up examination were reported as mean differences (95% CI), and the Pearson correlation test was used to assess correlation between statistically significant geometric changes and left ventricular (LV) volumes and function. Results Thirty participants (mean age, 68 years ± 9 [SD]; 25 male participants) underwent cardiac CT imaging after a median long-term follow-up of 9.0 years (IQR, 8.4-9.4). There were reductions in end-systolic A2 leaflet angle (-4° [95% CI: -7, -2]), end-systolic tenting height (-1 mm [95% CI: -2, -1]), and end-systolic and end-diastolic interpapillary muscle distances (-4 mm [95% CI: -6, -2]) compared with pre-CRT implantation values. The mitral valve annulus area remained unchanged. LV end-diastolic and end-systolic volumes decreased (-68 mL [95% CI: -99, -37] and -67 mL [95% CI: -96, -39], respectively), and LV ejection fraction increased (13% [95% CI: 7, 19]) at the long-term follow-up examination. Changes in interpapillary muscle distances showed moderate to strong correlations with LV volumes (r = 0.42-0.72; P < .05), while A2 leaflet angle and tenting height were not correlated to LV volumes or function. Conclusion Among the various geometric changes in the mitral valve apparatus after long-term CRT, the reduction in interpapillary muscle distances correlated with LV volumes while the reduced A2 leaflet angle and tenting height did not correlate with LV volumes. Keywords: Mitral Valve Apparatus, Cardiac Resynchronization Therapy, Cardiac CT Supplemental material is available for this article. © RSNA, 2024.

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用心脏 CT 评估长期心脏再同步化疗法期间二尖瓣器械的几何变化
目的 使用心脏 CT 评估接受心脏再同步化疗法(CRT)的患者二尖瓣器械的长期几何变化。材料和方法 邀请在 CRT 植入前和随访 6 个月时接受心脏 CT 检查的随机对照试验(Clinicaltrials.gov identifier NCT01323686)参与者接受额外的长期随访心脏 CT 检查。对二尖瓣器械的几何形状进行了评估,包括二尖瓣瓣环面积、A2瓣叶角度、瓣翼高度和瓣间肌距离。长期随访检查的几何变化以平均差(95% CI)的形式报告,并使用皮尔逊相关性检验来评估具有统计学意义的几何变化与左心室(LV)容积和功能之间的相关性。结果 30 名参与者(平均年龄为 68 岁 ± 9 [SD];25 名男性参与者)在中位数为 9.0 年(IQR,8.4-9.4)的长期随访后接受了心脏 CT 成像检查。与CRT植入前的值相比,收缩末期A2瓣叶角度(-4° [95% CI:-7,-2])、收缩末期瓣叶高度(-1 mm [95% CI:-2,-1])以及收缩末期和舒张末期乳头肌间距离(-4 mm [95% CI:-6,-2])均有所下降。二尖瓣瓣环面积保持不变。在长期随访检查中,左心室舒张末期容积和收缩末期容积分别下降(-68 mL [95% CI: -99, -37]和-67 mL [95% CI: -96, -39]),左心室射血分数增加(13% [95% CI: 7, 19])。乳头肌间距离的变化与左心室容积呈中度至高度相关(r = 0.42-0.72; P < .05),而 A2 小叶角度和帐篷高度与左心室容积或功能无关。结论 在长期CRT后二尖瓣器械的各种几何变化中,瓣间肌距离的减少与左心室容积相关,而A2瓣叶角度和瓣翼高度的减少与左心室容积无关。关键词二尖瓣装置 心脏再同步化治疗 心脏CT 本文有补充材料。© RSNA, 2024.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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Association of Aortic Stiffness with Heart Failure with Preserved Ejection Fraction: New Insights into the Ventriculoarterial Connection. Severe Quadricuspid Pulmonary Valve Stenosis Presenting as Scrotal Edema. Collateral Circulation in Coarctation. Geometric Changes in Mitral Valve Apparatus during Long-term Cardiac Resynchronization Therapy as Assessed with Cardiac CT. Clinically Relevant Extracardiac Findings at Cardiac Imaging: Insights from the European MR/CT Registry.
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