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Comparative study of the mitral valve anulus and of the left ventricle in dilated cardiomyopathy

OBJECTIVE: The aim of this investigation was to analyze the behavior of the mitral valve anulus and of the left ventricle (LV) in dilated cardiomyopathy (DCM). MATERIAL AND METHODS: Sixty-eight hearts of adults males suffering from ischemic or idiopathic DCM were analyzed after formaldehyde fixation and 20 hearts from in former patients without cardiopathy. Images were obtained after digitalization of the perimeter of mitral anulus, insertion of the anterior and posterior cusps and of the fibrous and muscular portion, as well as of the internal perimeter of the LV, distance from the septum to the anterior and posterior papillary muscle and of the septum interventricular length. RESULTS: The analysis of the results showed proportionality, both of the fibrous portion (r² = 0.98) and of the muscular portion (r² = 0.99) of the anulus as related to the dilatation degree of the mitral valve. Linear regression revealed a proportion relationship between the perimeter of the anterior (r² = 0.96) and posterior (r² = 0.99) cusps. The LV dilation occurred in global and spherical shape in all segments. No proportional relationship was observed between the degree of dilation of the mitral anulus and of the LV. CONCLUSIONS: Contrary to previous thinking, the DCM of ischemic or idiopathic etiology, the dilation of the anulus occurs in a proportional form and not only in its posterior portion. The degree of LV dilation does not determine the degree of mitral anulus dilation as they occur independently. Such obeservations open new perspectives for the techniques of correction of mitral valve insuficiency in DMC.

Mitral valve; Mitral valve; Cardiomyopathy; Cardiomyopathy; Heart ventricle; Heart ventricle


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