JTCS Tips for Better Browsing
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Fabio Biscegli Jatene
Luiz Felipe Pinho Moreira
Elias Kallás
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hueb, A. C.
Right arrow Articles by de Oliveira, S. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hueb, A. C.
Right arrow Articles by de Oliveira, S. A.
Related Collections
Right arrow Congestive Heart Failure
Right arrow Valve disease
Right arrowRelated Article

J Thorac Cardiovasc Surg 2002;124:1216-1224
© 2002 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease (ACD)

Ventricular remodeling and mitral valve modifications in dilated cardiomyopathy: New insights from anatomic study

Alexandre Ciappina Hueb, MD, Fabio Biscegli Jatene, MD, Luiz Felipe Pinho Moreira, MD, Pablo Maria Pomerantzeff, MD, Elias Kallás, MD, Sérgio Almeida de Oliveira, MD, PhD

From the Heart Institute (InCor), Medical School, University of São Paulo, São Paulo, Brazil.

Received for publication Nov 29, 2001. Revisions requested; Feb 11, 2002 revisions received March 7, 2002. Accepted for publication March 26, 2002. Address for reprints: Alexandre Ciappina Hueb, MD, Rua Oscar Freire 1707 apto 22, CEP: 05409-011 São Paulo, SP, Brazil (E-mail: hueb{at}uol.com.br).

Objective: The purpose of this study was to analyze the behavior of the mitral valve ring and the left ventricle in dilated cardiomyopathy.
Methods: We analyzed 68 fixed adult human hearts, divided into 48 hearts with dilated cardiomyopathy of ischemic or idiopathic origin and 20 hearts free of pathologic heart conditions. Digital images of the mitral ring perimeter, attachment of the anterior and posterior leaflets, and fibrous and muscular portions were collected. We also measured the internal perimeter of the left ventricle, the distance from the septum to the anterior and posterior papillary muscles, the distance between the papillary muscles, and the extension of interventricular septum.
Results: The analysis of the results showed proportional distribution of the ring's fibrous portion (r2 = 0.98) and muscular portion (r2 = 0.99) according to the degree of mitral valve dilation. Linear regression revealed that the perimeters of anterior and posterior leaflet attachments (r2 = 0.96 and r2 = 0.98, respectively) also had a proportional relation. We did not observe proportionality between the degree of dilation of the mitral ring and the left ventricle. It was observed that dilation of the left ventricle takes place globally in its segments.
Conclusion: Differently from what was thought, in ischemic or idiopathic dilated cardiomyopathy, dilation of mitral ring is proportional and does not exclusively affect the posterior portion. The degree of left ventricular dilation does not determine the degree of dilation of the mitral ring because they are independent processes. These observations shed new light on the techniques used to correct mitral valve insufficiency in dilated cardiomyopathy.


Related Article

Does the intertrigonal distance dilate? Never say never
Patrick M. McCarthy
J. Thorac. Cardiovasc. Surg. 2002 124: 1078-1079. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 CirculationHome page
E. H. Stephens, T. C. Nguyen, A. Itoh, N. B. Ingels Jr, D. C. Miller, and K. J. Grande-Allen
The Effects of Mitral Regurgitation Alone Are Sufficient for Leaflet Remodeling
Circulation, September 30, 2008; 118(14_suppl_1): S243 - S249.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. A. Milano, M. A. Daneshmand, J. S. Rankin, E. Honeycutt, M. L. Williams, M. Swaminathan, L. Linblad, L. K. Shaw, D. D. Glower, and P. K. Smith
Survival Prognosis and Surgical Management of Ischemic Mitral Regurgitation
Ann. Thorac. Surg., September 1, 2008; 86(3): 735 - 744.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. Chaput, M. D. Handschumacher, F. Tournoux, L. Hua, J. L. Guerrero, G. J. Vlahakes, and R. A. Levine
Mitral Leaflet Adaptation to Ventricular Remodeling: Occurrence and Adequacy in Patients With Functional Mitral Regurgitation
Circulation, August 19, 2008; 118(8): 845 - 852.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. Lange, T. Guenther, B. Kiefer, C. Noebauer, W. Goetz, R. Busch, P. Tassani-Prell, B. Voss, and R. Bauernschmitt
Mitral valve repair with the new semirigid partial Colvin-Galloway Future annuloplasty band.
J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1087 - 1093.e4.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
P. W.M. Fedak, P. M. McCarthy, and R. O. Bonow
Evolving Concepts and Technologies in Mitral Valve Repair
Circulation, February 19, 2008; 117(7): 963 - 974.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
E. Lansac, I. Di Centa, N. Al Attar, D. Messika-Zeitoun, R. Raffoul, A. Vahanian, and P. Nataf
Percutaneous mitral annuloplasty through the coronary sinus: an anatomic point of view.
J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 376 - 381.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
U. Sartipy, A. Albage, E. Mattsson, and D. Lindblom
Edge-to-Edge Mitral Repair Without Annuloplasty in Combination With Surgical Ventricular Restoration
Ann. Thorac. Surg., April 1, 2007; 83(4): 1303 - 1309.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Horii, H. Suma, T. Isomura, F. Nomura, and J. Hoshino
Left ventricle volume affects the result of mitral valve surgery for idiopathic dilated cardiomyopathy to treat congestive heart failure.
Ann. Thorac. Surg., October 1, 2006; 82(4): 1349 - 1355.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. J. Mack
Coronary Sinus in the Management of Functional Mitral Regurgitation: The Mother Lode or Fool's Gold?
Circulation, August 1, 2006; 114(5): 363 - 364.
[Full Text] [PDF]

Home page
 CirculationHome page
M. T. Spoor, A. Geltz, and S. F. Bolling
Flexible Versus Nonflexible Mitral Valve Rings for Congestive Heart Failure: Differential Durability of Repair
Circulation, July 4, 2006; 114(1_suppl): I-67 - I-71.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. J. Mack
Percutaneous Mitral Valve Repair: A Fertile Field of Innovative Treatment Strategies
Circulation, May 16, 2006; 113(19): 2269 - 2271.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
Pitfalls and limitations in measuring and interpreting the outcomes of mitral valve repair.
J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 523 - 529.


Home page
 HeartHome page
J M Ferrao de Oliveira and M. J Antunes
Mitral valve repair: better than replacement
Heart, February 1, 2006; 92(2): 275 - 281.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
E. A. Grossi, P. C. Saunders, Y. J. Woo, D. M. Gangahar, J. C. Laschinger, D. C. Kress, M. P. Caskey, C. F. Schwartz, and J. Wudel
Intraoperative Effects of the Coapsys Annuloplasty System in a Randomized Evaluation (RESTOR-MV) of Functional Ischemic Mitral Regurgitation
Ann. Thorac. Surg., November 1, 2005; 80(5): 1706 - 1711.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
S. Kaji, M. Nasu, A. Yamamuro, K. Tanabe, K. Nagai, T. Tani, K. Tamita, K. Shiratori, M. Kinoshita, M. Senda, et al.
Annular Geometry in Patients With Chronic Ischemic Mitral Regurgitation: Three-Dimensional Magnetic Resonance Imaging Study
Circulation, August 30, 2005; 112(9_suppl): I-409 - I-414.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. A.F. Tulner, P. Steendijk, R. J.M. Klautz, J. J. Bax, M. I.M. Versteegh, E. E. van der Wall, and R. A.E. Dion
Acute hemodynamic effects of restrictive mitral annuloplasty in patients with end-stage heart failure: Analysis by pressure-volume relations
J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 33 - 40.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
T. A. Vassiliades Jr, P. C. Block, L. H. Cohn, D. H. Adams, J. S. Borer, T. Feldman, D. R. Holmes, W. K. Laskey, B. W. Lytle, M. J. Mack, et al.
The Clinical Development of Percutaneous Heart Valve Technology: A Position Statement of the Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), and the Society for Cardiovascular Angiography and Interventions (SCAI) Endorsed by the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA)
J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1554 - 1560.
[Full Text] [PDF]

Home page
 CirculationHome page
P. C. Block
Percutaneous Mitral Valve Repair: Are They Changing the Guard?
Circulation, May 3, 2005; 111(17): 2154 - 2156.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
American College of Cardiology Foundation (ACCF) a, T. A. Vassiliades Jr, P. C. Block, L. H. Cohn, D. H. Adams, J. S. Borer, T. Feldman, D. R. Holmes, W. K. Laskey, B. W. Lytle, et al.
The clinical development of percutaneous heart valve technology: A position statement of the Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), and the Society for Cardiovascular Angiography and Interventions (SCAI)
J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 970 - 976.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. A. Vassiliades Jr, P. C. Block, L. H. Cohn, D. H. Adams, J. S. Borer, T. Feldman, D. R. Holmes, W. K. Laskey, B. W. Lytle, M. J. Mack, et al.
The Clinical Development of Percutaneous Heart Valve Technology: A Position Statement of The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), and the Society for Cardiovascular Angiography and Interventions (SCAI)
Ann. Thorac. Surg., May 1, 2005; 79(5): 1812 - 1818.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
E. C. McGee Jr, A. M. Gillinov, E. H. Blackstone, J. Rajeswaran, G. Cohen, F. Najam, T. Shiota, J. F. Sabik, B. W. Lytle, P. M. McCarthy, et al.
Recurrent mitral regurgitation after annuloplasty for functional ischemic mitral regurgitation
J. Thorac. Cardiovasc. Surg., December 1, 2004; 128(6): 916 - 924.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. M. Ahmad, A. M. Gillinov, P. M. McCarthy, E. H. Blackstone, C. Apperson-Hansen, J. X. Qin, D. Agler, T. Shiota, and D. M. Cosgrove
Annular Geometry and Motion in Human Ischemic Mitral Regurgitation: Novel Assessment With Three-Dimensional Echocardiography and Computer Reconstruction
Ann. Thorac. Surg., December 1, 2004; 78(6): 2063 - 2068.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. J. Byrne, D. M. Kaye, M. Mathis, D. G. Reuter, C. A. Alferness, and J. M. Power
Percutaneous Mitral Annular Reduction Provides Continued Benefit in an Ovine Model of Dilated Cardiomyopathy
Circulation, November 9, 2004; 110(19): 3088 - 3092.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. M. Parish, B. M. Jackson, Y. Enomoto, R. C. Gorman, and J. H. Gorman III
The Dynamic Anterior Mitral Annulus
Ann. Thorac. Surg., October 1, 2004; 78(4): 1248 - 1255.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. A. de Oliveira
Invited commentary
Ann. Thorac. Surg., June 1, 2004; 77(6): 1988 - 1988.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. K. Bhudia, P. M. McCarthy, N. G. Smedira, B.-K. Lam, J. Rajeswaran, and E. H. Blackstone
Edge-to-edge (Alfieri) mitral repair: results in diverse clinical settings
Ann. Thorac. Surg., May 1, 2004; 77(5): 1598 - 1606.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. Pretre, A. Kadner, H. Dave, D. Bettex, and M. I. Turina
Overlapping annuloplasty of the mitral valve in children
Ann. Thorac. Surg., May 1, 2004; 77(5): 1857 - 1859.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. Sharony, P. C. Saunders, A. Nayar, E. McAleer, A. C. Galloway, J. Delianides, C. F. Schwartz, R. M. Applebaum, I. Kronzon, S. B. Colvin, et al.
Semirigid partial annuloplasty band allows dynamic mitral annular motion and minimizes valvular gradients: an echocardiographic study
Ann. Thorac. Surg., February 1, 2004; 77(2): 518 - 522.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. A. Timek, G. R. Green, F. A. Tibayan, D. T. Lai, F. Rodriguez, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller
Aorto-mitral annular dynamics
Ann. Thorac. Surg., December 1, 2003; 76(6): 1944 - 1950.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
F. A. Tibayan, F. Rodriguez, F. Langer, M. K. Zasio, L. Bailey, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller
Annular remodeling in chronic ischemic mitral regurgitation: ring selection implications
Ann. Thorac. Surg., November 1, 2003; 76(5): 1549 - 1555.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. H. Gorman III, R. C. Gorman, B. M. Jackson, Y. Enomoto, M. G. St. John-Sutton, and L. H. Edmunds Jr
Annuloplasty ring selection for chronic ischemic mitral regurgitation: lessons from the ovine model
Ann. Thorac. Surg., November 1, 2003; 76(5): 1556 - 1563.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Kollar, V. Kekesi, P. Soos, and A. Juhasz-Nagy
Left ventricular external subannular plication: an indirect off-pump mitral annuloplasty method in a canine model
J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 977 - 982.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
E. A. Grossi, R. Sharony, and S. B. Colvin
Mitral valve in ischemic versus idiopathic dilated cardiomyopathy
J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 922 - 922.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. M. McCarthy
Does the intertrigonal distance dilate? Never say never
J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1078 - 1079.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2002 by The American Association for Thoracic Surgery.