Article (Scientific journals)
Histopathological maladaptive changes in the explanted human mitral leaflets correlate with changes in echocardiographic leaflet morphology and the severity of ischaemic mitral regurgitation.
Avila-Vanzzini, Nydia; LANCELLOTTI, Patrizio; Fernandez Calix, Luis Alberto et al.
2023In European Heart Journal. Cardiovascular Imaging
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Keywords :
echocardiography; histopathology; ischaemic mitral regurgitation; leaflet stiffness and thickness
Abstract :
[en] AIMS: Several changes of the mitral valve (MV) morphology have been previously documented in ischaemic mitral regurgitation (IMR) upon macro and microscopic examination. This study aimed to correlate echocardiographic MV thickening with IMR severity and to delineate the histopathological basis of valve thickening from the explanted leaflets. METHODS AND RESULTS: Two hundred and fifty patients were included in the echo-group; of these, 48 patients (19.2%) underwent surgical mitral valve replacement (MVR), including them in the histology-group. By echocardiography, the thickness of the anterior and posterior leaflet was more extensive in moderate to severe IMR, P < 0.001. Histology-group: patients were divided into two groups based on the median thickness: those with cusp thickness <0.42 cm in Group 1, and ≥0.42 cm in Group 2. The thickness of the base and cusp was more significant in Group 2, P < 0.05 in both. Group 2 biopsies were characterized by involvement of the three leaflet segments, myxoid tissue, and fibrosis deposition. Thicker leaflets were associated with a greater degree of mitral regurgitation (MR), P < 0.0001. In the echo-group, a median leaflet thickness of 3.5 mm of the anterior and posterior MV was independently associated with moderate to severe ischaemic MR [odds ratio (OR) 2.88, P < 0.01] and (OR 10.8, P < 0.001), respectively. CONCLUSION: In ischaemic MR, the thicker the cusps, the worse the MR. Leaflet thickening was due to the myxoid and fibrosis deposition and was detected by echocardiography. Therefore, this method can be helpful in the evaluation of valve remodelling.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Avila-Vanzzini, Nydia ;  Department of Out-Patient Care, National Institute of Cardiology Ignacio Chavez
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie ; Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy. ; Anthea Hospital, Bari, Italy.
Fernandez Calix, Luis Alberto;  Department of Out-Patient Care, National Institute of Cardiology Ignacio Chavez,
De León López, Wilman;  Department of Out-Patient Care, National Institute of Cardiology Ignacio Chavez,
Berrios-Bárcenas, Enrique;  Department of Out-Patient Care, National Institute of Cardiology Ignacio Chavez,
Aranda-Fraustro, Alberto;  Pathology Department, National Institute of Cardiology Ignacio Chavez, Mexico
Jordan-Rios, Antonio ;  Department of Out-Patient Care, National Institute of Cardiology Ignacio Chavez
Herrera-Bello, Hector;  Cardiology department, Medica Sur Clinical Foundation, Mexico City, Mexico.
Rivera-Lara, Pedro;  Coronary Unit department, Coronary Unit CMN siglo XXI, Mexico City, Mexico.
Arias-Godínez, Jose Antonio;  Echocardiography Department, National Institute of Cardiology, Mexico City,
Vannan, Mani A;  Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, GA, USA.
Language :
English
Title :
Histopathological maladaptive changes in the explanted human mitral leaflets correlate with changes in echocardiographic leaflet morphology and the severity of ischaemic mitral regurgitation.
Publication date :
2023
Journal title :
European Heart Journal. Cardiovascular Imaging
ISSN :
2047-2404
eISSN :
2047-2412
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: journals.permissions@oup.com.
Available on ORBi :
since 18 May 2022

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