Advanced

Contribution of mitral annular excursion and shape dynamics to total left ventricular volume change

Carlhäll, C; Wigström, L; Heiberg, Einar LU ; Karlsson, M; Bolger, A F and Nylander, E (2004) In American Journal of Physiology: Heart and Circulatory Physiology 287(4). p.1836-1841
Abstract
The mitral annulus (MA) has a complex shape and motion, and its excursion has been correlated to left ventricular (LV) function. During the cardiac cycle the annulus' excursion encompasses a volume that is part of the total LV volume change during both filling and emptying. Our objective was to evaluate the contribution of MA excursion and shape variation to total LV volume change. Nine healthy subjects aged 56 +/- 11 (means +/- SD) years underwent transesophageal echocardiography (TEE). The MA was outlined in all time frames, and a four-dimensional (4-D) Fourier series was fitted to the MA coordinates (3-D+time) and divided into segments. The annular excursion volume (AEV) was calculated based on the temporally integrated product of the... (More)
The mitral annulus (MA) has a complex shape and motion, and its excursion has been correlated to left ventricular (LV) function. During the cardiac cycle the annulus' excursion encompasses a volume that is part of the total LV volume change during both filling and emptying. Our objective was to evaluate the contribution of MA excursion and shape variation to total LV volume change. Nine healthy subjects aged 56 +/- 11 (means +/- SD) years underwent transesophageal echocardiography (TEE). The MA was outlined in all time frames, and a four-dimensional (4-D) Fourier series was fitted to the MA coordinates (3-D+time) and divided into segments. The annular excursion volume (AEV) was calculated based on the temporally integrated product of the segments' area and their incremental excursion. The 3-D LV volumes were calculated by tracing the endocardial border in six coaxial planes. The AEV (10 +/- 2 ml) represented 19 +/- 3% of the total LV stroke volume (52 +/- 12 ml). The AEV correlated strongly with LV stroke volume (r = 0.73; P < 0.05). Peak MA area occurred during middiastole, and 91 +/- 7% of reduction in area from peak to minimum occurred before the onset of LV systole. The excursion of the MA accounts for an important portion of the total LV filling and emptying in humans. These data suggest an atriogenic influence on MA physiology and also a sphincter-like action of the MA that may facilitate ventricular filling and aid competent valve closure. This 4-D TEE method is the first to allow noninvasive measurement of AEV and may be used to investigate the impact of physiological and pathological conditions on this important aspect of LV performance. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Physiology: Heart and Circulatory Physiology
volume
287
issue
4
pages
1836 - 1841
publisher
American Physiological Society
external identifiers
  • pmid:15205168
  • scopus:4744347159
ISSN
1522-1539
DOI
10.1152/ajpheart.00103.2004
language
English
LU publication?
yes
id
f05cc5d8-fb3b-4f15-ade4-66d4d6288a35 (old id 1129346)
date added to LUP
2008-06-12 16:13:28
date last changed
2017-12-10 03:43:18
@article{f05cc5d8-fb3b-4f15-ade4-66d4d6288a35,
  abstract     = {The mitral annulus (MA) has a complex shape and motion, and its excursion has been correlated to left ventricular (LV) function. During the cardiac cycle the annulus' excursion encompasses a volume that is part of the total LV volume change during both filling and emptying. Our objective was to evaluate the contribution of MA excursion and shape variation to total LV volume change. Nine healthy subjects aged 56 +/- 11 (means +/- SD) years underwent transesophageal echocardiography (TEE). The MA was outlined in all time frames, and a four-dimensional (4-D) Fourier series was fitted to the MA coordinates (3-D+time) and divided into segments. The annular excursion volume (AEV) was calculated based on the temporally integrated product of the segments' area and their incremental excursion. The 3-D LV volumes were calculated by tracing the endocardial border in six coaxial planes. The AEV (10 +/- 2 ml) represented 19 +/- 3% of the total LV stroke volume (52 +/- 12 ml). The AEV correlated strongly with LV stroke volume (r = 0.73; P &lt; 0.05). Peak MA area occurred during middiastole, and 91 +/- 7% of reduction in area from peak to minimum occurred before the onset of LV systole. The excursion of the MA accounts for an important portion of the total LV filling and emptying in humans. These data suggest an atriogenic influence on MA physiology and also a sphincter-like action of the MA that may facilitate ventricular filling and aid competent valve closure. This 4-D TEE method is the first to allow noninvasive measurement of AEV and may be used to investigate the impact of physiological and pathological conditions on this important aspect of LV performance.},
  author       = {Carlhäll, C and Wigström, L and Heiberg, Einar and Karlsson, M and Bolger, A F and Nylander, E},
  issn         = {1522-1539},
  language     = {eng},
  number       = {4},
  pages        = {1836--1841},
  publisher    = {American Physiological Society},
  series       = {American Journal of Physiology: Heart and Circulatory Physiology},
  title        = {Contribution of mitral annular excursion and shape dynamics to total left ventricular volume change},
  url          = {http://dx.doi.org/10.1152/ajpheart.00103.2004},
  volume       = {287},
  year         = {2004},
}