Assuntos
Paraganglioma/complicações , Neoplasias Retroperitoneais/patologia , Choque Cardiogênico/etiologia , Adolescente , Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Doxazossina/administração & dosagem , Doxazossina/uso terapêutico , Quimioterapia Combinada , Oxigenação por Membrana Extracorpórea/métodos , Humanos , Labetalol/administração & dosagem , Labetalol/uso terapêutico , Masculino , Paraganglioma/tratamento farmacológico , Paraganglioma/cirurgia , Cuidados Pré-Operatórios , Recidiva , Neoplasias Retroperitoneais/diagnóstico por imagem , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
INTRODUCTION AND OBJECTIVES: Atrial fibrillation can lead to left atrium remodelling and induce functional mitral regurgitation. The aim of this study is to establish those features of the mitral annulus that are related to atrial functional mitral regurgitation. METHODS: A total of 29 patients with persistent atrial fibrillation and 36 controls in sinus rhythm were retrospectively enrolled. The characteristics of the mitral annulus were analysed by three-dimensional transoesophageal echocardiography in both groups. The 2D and 3D echocardiographic parameters were correlated with the effective regurgitant orifice. RESULTS: Patients with atrial fibrillation had a larger left atrium volume, anteroposterior diameter at end-diastole, and lower percentage of change in this diameter (P=.015, P=.019 and P<.001, respectively). In the multiple regression analysis, the ellipticity index (ß: -0.756, P=.004) and height-anterolateral-posteromedial diameter ratio (ß: -0704, P=.003) were independent parameters that correlated with the effective regurgitant orifice (R2: 0.699, P=.019) in patients with atrial fibrillation. CONCLUSIONS: Atrial fibrillation leads to atrial dilation and alterations in the size and dynamics of the anteroposterior diameter, producing a circular mitral annulus. The independent determining factors of atrial functional mitral regurgitation in the atrial fibrillation group were the ellipticity index and the height-anterolateral-posteromedial diameter ratio.
Assuntos
Fibrilação Atrial/complicações , Ecocardiografia Tridimensional/métodos , Ecocardiografia Transesofagiana/métodos , Insuficiência da Valva Mitral/diagnóstico por imagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/etiologia , Análise de Regressão , Estudos RetrospectivosRESUMO
Resumen Introducción y objetivos: La fibrilación auricular puede producir remodelado de la aurícula izquierda e inducir insuficiencia mitral funcional. El objetivo de este estudio es establecer qué características del anillo mitral están relacionadas con la regurgitación mitral funcional auricular. Método: Restrospectivamente se reclutaron 29 pacientes en fibrilación auricular persistente y 36 en ritmo sinusal. Las características del anillo mitral mediante ecocardiografía transesofágica tridimensional fueron analizadas en ambos grupos. Los parámetros ecocardiográficos 2D y 3D fueron correlacionados con el orificio regurgitante efectivo. Resultados: Los pacientes con fibrilación auricular presentaron mayor volumen de aurícula izquierda, diámetro anteroposterior al final de la diástole y disminución de su porcentaje de cambio (p: 0.015, 0.019 y < 0.001 respectivamente). En el análisis de regresión multivariante el índice de elipticidad (ˇ: −0.756, p: 0.004) y el ratio altura/diámetro anterolateral posteromedial (ˇ: −0.704, p: 0.003) fueron parámetros independientes correlacionados con el orificio regurgitante efectivo (R2: 0.699, p: 0.019) en pacientes con fibrilación auricular. Conclusiones: La fibrilación auricular produce cambios en el tamaño y dinámica del diámetro anteroposterior, lo que provoca un anillo mitral circular. Los mayores determinantes de la insuficiencia mitral funcional auricular en el grupo de fibrilación auricular resultaron el índice de elipticidad y el ratio altura/diámetro anterolateral-posteromedial.
Abstract Introduction and objectives: Atrial fibrillation can lead to left atrium remodelling and induce functional mitral regurgitation. The aim of this study is to establish those features of the mitral annulus that are related to atrial functional mitral regurgitation. Methods: A total of 29 patients with persistent atrial fibrillation and 36 controls in sinus rhythm were retrospectively enrolled. The characteristics of the mitral annulus were analysed by three-dimensional transoesophageal echocardiography in both groups. The 2D and 3D echocardiographic parameters were correlated with the effective regurgitant orifice. Results: Patients with atrial fibrillation had a larger left atrium volume, anteroposterior diameter at end-diastole, and lower percentage of change in this diameter (P = .015, P = .019 and P < .001, respectively). In the multiple regression analysis, the ellipticity index (ˇ: −0.756, P = .004) and height-anterolateral-posteromedial diameter ratio (ˇ: −0704, P = .003) were independent parameters that correlated with the effective regurgitant orifice (R2: 0.699, P = .019) in patients with atrial fibrillation. Conclusions: Atrial fibrillation leads to atrial dilation and alterations in the size and dynamics of the anteroposterior diameter, producing a circular mitral annulus. The independent determining factors of atrial functional mitral regurgitation in the atrial fibrillation group were the ellipticity index and the height-anterolateral-posteromedial diameter ratio.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Fibrilação Atrial/complicações , Ecocardiografia Transesofagiana/métodos , Ecocardiografia Tridimensional/métodos , Insuficiência da Valva Mitral/diagnóstico por imagem , Análise de Regressão , Estudos Retrospectivos , Insuficiência da Valva Mitral/etiologiaRESUMO
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