A34 - Impact of Mitral and Aortic Valve Regurgitation on the Right Ventricular Shape and Function: A 3D Echocardiography Study

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Support:The development of this supplement was funded by Abiomed.

Correspondence Details:Hoda Abdelgawad,

Open Access:

The copyright in this work belongs to Radcliffe Medical Media. Only articles clearly marked with the CC BY-NC logo are published with the Creative Commons by Attribution Licence. The CC BY-NC option was not available for Radcliffe journals before 1 January 2019. Articles marked ‘Open Access’ but not marked ‘CC BY-NC’ are made freely accessible at the time of publication but are subject to standard copyright law regarding reproduction and distribution. Permission is required for reuse of this content.

Background: Left ventricular (LV) volume overload due to mitral (MR) or aortic valve (AR) regurgitation may affect right ventricular (RV) geometry and function. Increase in pulmonary artery systolic pressure (PASP) may impair RV performance in patients with chronic MR. However, the effects of chronic LV volume overload due to AR on RV shape and function remains to be clarified.

Hypothesis: The aim of this study was to compare the effects of LV volume overload due to chronic organic MR or AR on RV shape and function.

Results: LV end-diastolic volume (EDVi) was significantly larger in patients with AR than those with MR (107 ± 36 ml/m2 versus 79 ± 20 ml/m2, p<0.001). RV ejection fraction (RVEF) (40 ± 6% versus 43 ± 8%, p=0.037) and RV fractional area change (FAC; 34 ± 9% versus 37 ± 9, p=0.04) were lower in patients with AR than those with MR. The RV eccentricity index was significantly higher in the AR group (2.5 ± 0.6 versus 2.1 ± 0.5, p=0.003). In both groups, LV EDVi showed a positive correlation with RV shape (RV eccentricity: r=0.693 for AR and r=0.525 for MR; p<0.001) and negative correlation with RV function (RVEF: r=−0545 for AR and r=−0.383 for MR, p<0.001; RV FAC: r=−0.816 for AR and r=−0.647 for MR, p<0.001).

Conclusion: Beyond the classical, but weak, effect of elevated PASP, RV remodelling in chronic LV volume overload owing to AR and MR can result from a complex interaction with the remodelled and enlarged LV.