Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

To describe the detailed geometric changes in the mitral valve apparatus occurring in patients with left ventricular dysfunction and functional mitral regurgitation. Prospective study that included 40 patients who had left ventricular systolic dysfunction and functional mitral regurgitation of varying severity from June 2015 to June 2016 referred to the department of Cardiovascular Medicine Cairo university; they were divided into two groups according to the coronary angiography (done at least within 30 days next to their enrollment): group 1: 25 patients (LV dysfunction is due ischemic cardiomyopathy) and group 2: 15 patients (LV dysfunction is due to idiopathic dilated cardiomyopathy). We evaluated the different deformity indices of the mitral valve apparatus in these patients using 2D and 3D echocardiography with the new mitral valve navigation software, and compared the results between the two study groups. The effective regurgitant orifice area (EROA), as an index of mitral regurgitation severity, was positively correlated with mitral valve anteroposterior diameter, mitral valve annular 3 dimensional (3D) circumference, mitral valve annular 2 dimensional area, mitral valve annular 3D area, mitral valve anterior and posterior leaflet 3D area, mitral valve tenting volume and tenting height, and annular ellipsicity in the whole study population. The mitral annular area, anterolateral and posteromedial tethering showed a strong correlation with indices of left ventricular dysfunction. There was no significant relationship between mitral regurgitation severity indices and those of LV systolic dysfunction as measured by left ventricular ejection fraction

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