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ABSTRACT 96
THE NEW PATHWAY OF MITRAL ANNULUS DILATION
IN DILATED CARDIOMYOPATHIES: ANATOMIC STUDY
F.B. Jatene, A.C. Hueb: L.F. Moreira; P.M Pomerantzeff;
M.B. Jatene; R.C. Chabelmann; B.M. Mioto; S.A. Oliveira
Heart Institute(INCOR), University of Sao Paulo Medical
School, Sao Paulo, Brazil
To assess and compare mitral ring in ischemic and idiopathic
dilated cardiomyopathy with normal hearts. Sixty-eight hearts
were divided into: GROUP I- 48 hearts with ischemic (24) or idiopathic
(24) cardiomyopathy; GROUP II- 20 normal hearts. The "in
vivo" echocardiogram was obtained to asses and quantify mitral
regurgitation. After the hearts were prepared, digital pictures
of mitral valve and the left ventricular cavity were obtained
and measured by a computer software.
Observed increase in the ring area, perimeter, anterior and posterior
cusp insertion perimeter and the length between the fibrous trigones
of the mitral valve in hearts with cardiomyopathy compared to
normal hearts (p=0.0001). Left ventricular perimeter increase
when compared to normal hearts (p=0.0001). There is no
relationship between the left ventricular perimeter with the perimeter
of the mitral ring. There is a proportional increase between the
length between the fibrous trigones as well as in the insertion
perimeter of the anterior and posterior cusp of the mitral valve
(r2= 0.96). The presence of significant mitral
regurgitation is related to a greater increase of the mitral ring,
especially where the length between the fibrous trigones is greater.
In conclusion the anterior portion of the mitral annulus is
involved in annular dilation in dilated cardiomyopathies.
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