{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:07:47Z","timestamp":1700698067393},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T00:00:00Z","timestamp":1363219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ischemic mitral regurgitation (<jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content>) is common in ischemic heart disease and results in poor prognosis. However, the exact mechanism of <jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content> has not been fully elucidated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Quantitation of the  mitral tetrahedron using three\u2010dimentianl (3D) echocardiography is capable of evaluating the geometric determinants and mechanisms of IMR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty patients with a history of <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\u2010elevation myocardial infarction at least 6 months earlier were studied. Parameters of mitral deformation and global left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) function and shape were evaluated by 2\u2010dimensional echocardiography. The effective regurgitant orifice (<jats:styled-content style=\"fixed-case\">ERO<\/jats:styled-content>) of <jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content> was obtained by the quantitative continuous\u2010wave Doppler technique. Three\u2010dimensional (<jats:styled-content style=\"fixed-case\">3D<\/jats:styled-content>) echocardiography was applied to assess the mitral tetrahedron.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mitral valvular tenting area (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), mitral annular area (<jats:italic>P<\/jats:italic>\u2009=\u20090.032), dilation of the <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> in diastole, impairment of the <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> ejection fraction, and volume of the spherically shaped <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> in systole were greater in patients with an <jats:styled-content style=\"fixed-case\">ERO<\/jats:styled-content> \u226520 mm<jats:sup>2<\/jats:sup> than in those with an <jats:styled-content style=\"fixed-case\">ERO<\/jats:styled-content> &lt;20 mm<jats:sup>2<\/jats:sup>. In the mitral tetrahedron, only the interpapillary muscle roots distance showed a significant difference (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). Multivariate analysis with the logistic regression model showed the systolic mitral tenting area (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>]: 280.49, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 4.59\u20101.72\u2009\u00d7\u200910<jats:sup>4<\/jats:sup>, <jats:italic>P<\/jats:italic>\u2009=\u20090.007) and interpapillary muscle distance (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1.50, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.03\u20102.19, <jats:italic>P<\/jats:italic>\u2009=\u20090.036) to be independent factors in predicting significant <jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">ERO<\/jats:styled-content> \u226520 mm<jats:sup>2<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">3D<\/jats:styled-content> echocardiography can be effectively applied in measuring the mitral tetrahedron and evaluating the mechanism of <jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content>. Mitral valvular tenting and interpapillary muscle distance are 2 independent factors of significant <jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22111","type":"journal-article","created":{"date-parts":[[2013,3,15]],"date-time":"2013-03-15T03:47:24Z","timestamp":1363319244000},"page":"286-292","source":"Crossref","is-referenced-by-count":5,"title":["Quantitation of the Mitral Tetrahedron in Patients With Ischemic Heart Disease Using Real\u2010Time Three\u2010Dimensional Echocardiography to Evaluate the Geometric Determinants of Ischemic Mitral 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