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Structural and Functional Characteristics of Mitral Paravalvular Leakage Identified by Multimodal Imaging and Their Implication on Clinical Presentation
- Source :
- Journal of Clinical Medicine, Volume 10, Issue 2, Journal of Clinical Medicine, Vol 10, Iss 222, p 222 (2021)
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- Objective: Clinical presentation of patients with mitral paravalvular leakage (PVL) varies from asymptomatic to heart failure related with hemolytic anemia or pulmonary hypertension. We aimed to investigate the structural and functional characteristics of mitral PVL by multimodal imaging and their association with the severity of hemolysis and hemodynamic significance. Methods: A total of 74 patients with mitral PVL who underwent both cardiac computed tomography (CT) and echocardiography from March 2010 to December 2017 was investigated. Location and size of PVL, degree of left atrial (LA) calcification as measured by CT, and hemodynamic variables as measured by echocardiography were comprehensively analyzed. To investigate the degree of hemolysis and pulmonary hypertension, level of lactate dehydrogenase (LDH) and Doppler estimated systolic pulmonary artery pressure (SPAP) were used respectively. Results: Level of LDH was not related to PVL perimeter and was variable, especially in patients with a small PVL. However, it was positively correlated with mean mitral regurgitation velocity. Additionally, SPAP was significantly correlated with PVL perimeter and LA calcium score. In multivariable analysis, mean mitral regurgitation velocity was significantly correlated with levels of LDH (&beta<br />= 0.345<br />p = 0.016), and PVL perimeter and LA calcium score were independently associated with SPAP (&beta<br />= 0.249<br />p = 0.036 and &beta<br />= 0.467<br />p &lt<br />0.001, respectively). Conclusions: Characteristics of mitral PVL and adjacent structures are associated with the severity of hemolysis and pulmonary hypertension. Evaluating the structural and functional characteristics of mitral PVL by complementary multimodal imaging would be important for understanding the clinical presentation and deciding optimal treatments for individual patients.
- Subjects :
- Hemolytic anemia
medicine.medical_specialty
lcsh:Medicine
heart failure
Hemodynamics
multimodal imaging
030204 cardiovascular system & hematology
Asymptomatic
Article
03 medical and health sciences
mitral paravalvular leakage
0302 clinical medicine
Internal medicine
medicine.artery
pulmonary hypertension
medicine
030212 general & internal medicine
Mitral regurgitation
business.industry
lcsh:R
General Medicine
bacterial infections and mycoses
medicine.disease
Pulmonary hypertension
Heart failure
Pulmonary artery
cardiovascular system
Cardiology
hemolysis
medicine.symptom
business
Calcification
Subjects
Details
- ISSN :
- 20770383
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....622ec4583f0a52c1e4da9f50f59e4e03