Differences in Mitral Valve Geometry between Atrial and Ventricular Functional Mitral Regurgitation in Patients with Atrial Fibrillation: a 3D Transesophageal Echocardiography Study
Department of Cardiology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.
https://doi.org/10.21608/aimj.2025.446577
Abstract
Background: Functional mitral regurgitation (FMR) is commonly attributed to either atrial or ventricular dysfunction. Objective: This study aimed to investigate mitral valve geometric differences between atrial functional mitral regurgitation (A-FMR) and ventricular functional mitral regurgitation (V-FMR) using three-dimensional transesophageal echocardiography (3D-TEE). Patients and Methods: The study included 50 patients with non-valvular atrial fibrillation who had a clinical indication for echocardiography. These patients were classified into two groups based on the etiology of FMR: atrial and ventricular types. All patients visited the ECHO lab at Bab Al-Sharia Hospital, Al-Azhar University, between April 2023 and January 2025. Results: No significant differences were observed between the A-FMR and V-FMR groups in terms of effective regurgitant orifice area, regurgitation volume, or vena contracta width. However, the left atrium (LA) diameter was significantly larger in the V-FMR group (p=0.027). Additionally, the left ventricular end-systolic volume (LV-ESV) index and ejection fraction (EF) showed significant differences (p=0.001). While no significant differences were found in the anterior mitral leaflet (AML) and posterior mitral leaflet (PML) areas, the posterior mitral leaflet angles (central, lateral, and medial) differed significantly (p=0.001, 0.002, and 0.001, respectively). Mitral valve tenting volume and height also demonstrated significant differences (p=0.001 and 0.002, respectively). Conclusion: This study compared mitral valve features in atrial and ventricular functional mitral regurgitation. While both groups shared common characteristics, distinct differences were observed in left atrial diameter and mitral leaflet tethering, highlighting the importance of etiology-specific evaluation in FMR.
Atia, W., Elbeny, A., & Abdelwahid, A. (2025). Differences in Mitral Valve Geometry between Atrial and Ventricular Functional Mitral Regurgitation in Patients with Atrial Fibrillation: a 3D Transesophageal Echocardiography Study. Al-Azhar International Medical Journal, 2025(5), 191-196. doi: https://doi.org/10.21608/aimj.2025.446577
MLA
Wael Mohamed Atia; Ahmed Mohamed Elbeny; Ahmed Abdelraheem Abdelwahid. "Differences in Mitral Valve Geometry between Atrial and Ventricular Functional Mitral Regurgitation in Patients with Atrial Fibrillation: a 3D Transesophageal Echocardiography Study", Al-Azhar International Medical Journal, 2025, 5, 2025, 191-196. doi: https://doi.org/10.21608/aimj.2025.446577
HARVARD
Atia, W., Elbeny, A., Abdelwahid, A. (2025). 'Differences in Mitral Valve Geometry between Atrial and Ventricular Functional Mitral Regurgitation in Patients with Atrial Fibrillation: a 3D Transesophageal Echocardiography Study', Al-Azhar International Medical Journal, 2025(5), pp. 191-196. doi: https://doi.org/10.21608/aimj.2025.446577
VANCOUVER
Atia, W., Elbeny, A., Abdelwahid, A. Differences in Mitral Valve Geometry between Atrial and Ventricular Functional Mitral Regurgitation in Patients with Atrial Fibrillation: a 3D Transesophageal Echocardiography Study. Al-Azhar International Medical Journal, 2025; 2025(5): 191-196. doi: https://doi.org/10.21608/aimj.2025.446577
)
View on SCiNiTO