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Comparative Echocardiographic Analysis of Mitral and Tricuspid Annular Motion: Differences Explained with Proposed Anatomic‐Structural Correlates
Author(s) -
LópezCandales Angel,
Rajagopalan Navin,
Gulyasy Beth,
Edelman Kathy,
Bazaz Raveen
Publication year - 2007
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2006.00408.x
Subject(s) - cardiology , medicine , mitral annulus , excursion , ejection fraction , tricuspid valve , annulus (botany) , cardiac cycle , heart failure , diastole , blood pressure , materials science , political science , law , composite material
Background: Annular motion (AM) has been shown to occur during all dynamic phases of the cardiac cycle; but little is known regarding comparisons between mitral and tricuspid AM. We elected to use M‐mode to examine the extent and timing of mitral and tricuspid AM events. Methods: A complete echocardiogram was obtained in 50 patients [mean age 53 ± 16 years, mean left ventricular ejection fraction (LVEF) 57 ± 19%, and mean right ventricular fractional area change (RVFAC) of 49 ± 20%]. Timing of all AM intervals was corrected for heart rate. Results: A strong linear correlation was noted for both LVEF and maximal mitral annular systolic excursion and for RVFAC and maximal tricuspid annular systolic excursion (r = 0.91, P < 0.0001). The amplitude of both maximal mitral annular descent (1.54 ± 0.45 cm) and ascent (0.64 ± 0.23 cm) was significantly smaller than for the tricuspid annulus (2.26 ± 0.73 and 0.98 ± 0.37 cm; P < 0.0001, respectively). Furthermore, while it takes longer for the mitral than for the tricuspid annulus (403 ± 52 ms vs 308 ± 50 ms; P < 0.0001, respectively) to descend to its lowest point; the duration to reach maximal ascent is shorter for the mitral than for tricuspid annulus (90 ± 22 ms vs 115 ± 19 ms; p < 0.0001, respectively). Conclusion: Significant differences exist in both amplitude and timing of AM events between the mitral and tricuspid annuli, likely reflecting intrinsic anatomical and electromechanical differences between both sides of the heart that require further investigation.