M-mode and Cross-sectional Echocardiographic Evaluation of Rheumatic Mitral Valve Disease : SYMPOSIUM ON CURRENT TOPICS AND FUTURE PROSPECTS IN ECHOCARDIOGRAPHY

Native mitral valve disease is the second valvular heart disease after aortic valve disease. For the last few decades, two-dimensional Doppler echocardiography was the cornerstone technique for evaluating patients with mitral valve disease. Besides aetiological information, echocardiography allows the description of valve anatomy, the assessment of disease severity, and the description of the associated lesions.This chapter will address the echocardiographic evaluation of mitral regurgitation (MR) and mitral stenosis (MS).In MR, the following findings should be assessed: 1. Aetiology. 2. Type and extent of anatomical lesions and mechanisms of regurgitation. 3. The possibility of mitral valve repair. 4. Quantification of MR severity. 5. Quantification of MR repercussions.In MS, the following findings should be assessed: 1. Aetiology. 2. Type and extent of anatomical lesions. 3. Quantification of MS severity. 4. Quantification of MS repercussions. 5. Wilkins or Cormier scores for the possibility of percutaneous mitral commissuroplasty.Management of patients with mitral valve disease is currently based on symptoms and on echocardiographic evaluation at rest. Therefore, knowing how to assess the severity of valve diseases as well as the pitfalls and the limitations of each echocardiographic method is of primary importance.

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Blood lactate increases with the progression of mitral valve disease in dogs

Pesquisa Veterinária Brasileira ◽

10.1590/1678-5150-pvb-5169 ◽

2018 ◽

Vol 38 (9) ◽

pp. 1781-1786

Author(s):

Jorge Cardoso Silva-Filho ◽

Marlos G. Sousa ◽

Evandro Zacché Pereira ◽

Edna M.G. Ortiz ◽

Rodrigo P. Franco ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Mitral Valve ◽

Blood Lactate ◽

Cardiac Remodeling ◽

Mitral Valve Disease ◽

Lactate Concentration ◽

Tissue Perfusion ◽

Valve Disease ◽

Cross Sectional

ABSTRACT: In dogs with congestive heart failure, the upregulated sympathetic tone causes vasoconstriction that impairs peripheral blood supply, therefore causing the accumulation of lactate. In this prospective cross-sectional study with a longitudinal component, blood lactate was quantified in 10 healthy and 34 myxomatous mitral valve disease (MMVD) dogs to investigate its potential use as a diagnostic and prognostic biomarker. While there were no differences in lactate concentration between control animals and stages B1 (3.31±0.62mmol/L) and B2 (3.32±0.46mmol/L) dogs, significant differences were found between healthy (2.50±0.69mmol/L) and both C (3.99±0.47mmol/L) and D (6.97±1.23mmol/L) animals. When a cut-off of 3.35mmol/L was used, lactate was able to distinguish dogs with normal and remodeled hearts with a sensitivity of 78.2% and specificity of 63.6%. Also, significant correlations existed between lactate and indicators of cardiac remodeling. Finally, animals with blood lactate <3.5mmol/L carried a better prognosis when compared with dogs in which lactate was >5.0mmol/L. Our results suggest that the progression of MMVD results in accumulation of lactate within the bloodstream, which is likely attributable to the impaired peripheral tissue perfusion. In MMVD dogs, blood lactate may be used as a surrogate for cardiac remodeling, and an increased concentration is associated with a worse prognosis regarding the time to evolve into congestive heart failure.

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Echocardiographic evaluation of heart failure in dogs with myxomatous mitral valve disease: a retrospective study

Journal of Biomedical Translational Research ◽

10.12729/jbtr.2018.19.4.079 ◽

2018 ◽

Vol 19 (4) ◽

pp. 79-85

Author(s):

Donghyun Han ◽

Dong-Guk Lee ◽

Dong-In Jung

Keyword(s):

Heart Failure ◽

Retrospective Study ◽

Mitral Valve ◽

Mitral Valve Disease ◽

Valve Disease ◽

Echocardiographic Evaluation

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Cross-sectional early mitral flow-velocity profiles from color Doppler in patients with mitral valve disease.

Circulation ◽

10.1161/01.cir.86.3.748 ◽

1992 ◽

Vol 86 (3) ◽

pp. 748-755 ◽

Cited By ~ 12

Author(s):

S O Samstad ◽

O Rossvoll ◽

H G Torp ◽

T Skjaerpe ◽

L Hatle

Keyword(s):

Mitral Valve ◽

Flow Velocity ◽

Mitral Valve Disease ◽

Color Doppler ◽

Velocity Profiles ◽

Valve Disease ◽

Cross Sectional ◽

Mitral Flow

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Use of measurements from thoracic radiographs to identify high mean left atrium pressure in dogs with myxomatous mitral valve disease

Semina Ciências Agrárias ◽

10.5433/1679-0359.2019v40n1p191 ◽

2019 ◽

Vol 40 (1) ◽

pp. 191

Author(s):

Flavio Shigueru Jojima ◽

Stephany Buba Lucina ◽

Alexandre Leseur Santos ◽

Marlos Gonçalves Sousa ◽

Tilde Rodrigues Froes

Keyword(s):

Mitral Valve ◽

Left Atrium ◽

Mitral Valve Disease ◽

Vena Cava ◽

Cross Sectional Study ◽

Valve Disease ◽

Radiographic Measurement ◽

Cross Sectional ◽

Heart Score ◽

Radiographic Measurements

The aim of this study was to estimate echocardiographic elevated mean left atrium pressure (MLAP) based on measurements from thoracic radiographs and to determine a cut-off value for each radiographic measurement that suggests a high MLAP. A retrospective cross-sectional study was performed to include cases admitted from January 2015 to December 2016. Thoracic radiographic examinations from 93 dogs with and without a high MLAP were included. Specific measurements were made from thoracic radiographs and compared with echocardiographic variables known to indicate high MLAP. This comparison was used to generate equations that allowed the estimation of echocardiographic surrogates from the radiographic measurements. The values indicative of high MLAP were obtained using a regression curve. Formulas that indicated high MLAP were generated using a number of radiographic measurements. Positive echocardiographic findings of high MLAP were used as the gold standard. These formulas helped to predict high MLAP in myxomatous mitral valve disease (MMVD) without the need for echocardiographic examination. The best formula was left atrium (LA):aorta (Ao)echo = 0.03×(vertebral heart score,VHS) + 0.14×(LA) + 0.27×(LA:caudal vena cava (CVC)rad). Values ? 12.2v for VHS, ? 4.5cm for LA, ? 3.3 for LA:Aorad and ? 3.2 for LA:CVCrad suggested high MLAP. Thus, we propose equations, based on measurements from thoracic radiographs, to identify high MLAP. Simple radiographic thoracic measurements, such as LA:CVCrad, can be used to define overload and a high MLAP in dogs with MMVD.

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Study of Correlation of Left Atrial Size and Atrial Fibrillation in Rheumatic Mitral Valve Disease

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v17i2.28750 ◽

2019 ◽

Vol 17 (2) ◽

pp. 7-9

Author(s):

Anil Shrestha ◽

Richa Shrestha

Keyword(s):

Atrial Fibrillation ◽

Mitral Valve ◽

Sinus Rhythm ◽

Mitral Valve Disease ◽

Left Atrial ◽

Valve Disease ◽

Left Atrial Size ◽

Predisposing Factor ◽

Cross Sectional ◽

Atrial Size

Aim: To study the correlation between Atrial Fibrillation (AF) and left atrial size in Rheumatic Mitral valve disease (RMVD). Background: AF is the most common sustained cardiac arrhythmia which is associated with increased cardiovascular morbidity, mortality and preventable stroke. AF is common in rheumatic heart disease (RHD) particularly mitral stenosis (MS). LA dilatation is the predisposing factor for the development of AF in RMVD. Methodology: This is a hospital based cross sectional descriptive study conducted in 52 patients who were diagnosed as RMVD clinically and echocardiographically in NGMCTH, Kohalpur between December 2018 to November 2019. Detailed history and complete clinical examination were performed. Standard 12 lead ECG and 2-D echocardiography were done. Left atrial size was measured and compared with patients in AF and with sinus rhythm. Result: The age of patients ranged from 20-76 years with the mean age of 40.33 years. Out of 52 patients 30 were in AF and 23 in sinus rhythm. Among 30 patients in AF, 27 (90%) had LA size ≥ 4 cm with mean LA size of 4.6 cm whereas among 22 patients in sinus rhythm, 14 (63.64%) had LA Size <4 cm with a mean of 3.83 cm. Conclusion: Left atrial size ≥ 4 cm is the predisposing factor for the development of AF in rheumatic mitral valve disease. Therefore, if patients in sinus rhythm who are at high risk of developing AF are identified, prophylactic anticoagulation and antiarrythmic drug might prevent AF induced embolism and exacerbation of symptoms in rheumatic mitral valve disease.

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