000			03696nam a22005057a 4500
008			140403s20132013 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
040			_aOvid MEDLINE(R)
099			_a24035166
245			_aMechanisms of functional mitral regurgitation in ischemic cardiomyopathy determined by transesophageal echocardiography (from the Surgical Treatment for Ischemic Heart Failure Trial).
251			_aAmerican Journal of Cardiology. 112(11):1812-8, 2013 Dec 1.
252			_aAm J Cardiol. 112(11):1812-8, 2013 Dec 1.
253			_aThe American journal of cardiology
260			_c2013
260			_fFY2014
266			_d2014-04-04
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aThe mechanisms underlying functional mitral regurgitation (MR) and the relation between mechanism and severity of MR have not been evaluated in a large, multicenter, randomized controlled trial. Transesophageal echocardiography (TEE) was performed in 215 patients at 17 centers in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Both 2-dimensional (n = 215) and 3-dimensional (n = 81) TEEs were used to assess multiple quantitative measurements of the mechanism and severity of MR. By 2-dimensional TEE, leaflet tenting area, anterior and posterior leaflet angles, mitral annulus diameter, left ventricular (LV) end-systolic volume index, LV ejection fraction (LVEF), and sphericity index (p <0.05 for all) were significantly different across MR grades. By 3-dimensional TEE, mitral annulus area, leaflet tenting area, LV end-systolic volume index, LVEF, and sphericity index (p <0.05 for all) were significantly different across MR grades. A multivariate analysis showed a trend for annulus area (p = 0.069) and LV end-systolic volume index (p = 0.071) to predict effective regurgitant orifice area and for annulus area (p = 0.018) and LV end-systolic volume index (p = 0.073) to predict vena contracta area. In the STICH trial, multiple quantitative parameters of the mechanism of functional MR are related to MR severity. The mechanism of functional MR in ischemic cardiomyopathy is heterogeneous, but no single variable stands out as a strong predictor of quantitative severity of MR. Copyright 2013 Elsevier Inc. All rights reserved.
546			_aEnglish
650			_a*Cardiomyopathies/us [Ultrasonography]
650			_a*Mitral Valve Insufficiency/us [Ultrasonography]
650			_a*Mitral Valve/us [Ultrasonography]
650			_a*Myocardial Ischemia/us [Ultrasonography]
650			_aAged
650			_aCardiomyopathies/et [Etiology]
650			_aEchocardiography, Three-Dimensional
650			_aEchocardiography, Transesophageal
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aMitral Valve Insufficiency/et [Etiology]
650			_aMultivariate Analysis
650			_aMyocardial Ischemia/co [Complications]
650			_aProspective Studies
650			_aSeverity of Illness Index
650			_aStroke Volume
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
657			_aResearch Support, N.I.H., Extramural
700			_aAsch, Federico M
790			_aAsch FM, Aston S, Cherniavsky A, Drozdz J, Golba K, Grayburn PA, Haddad H, Handschumacher MD, Holly TA, Horton J, Kron I, Lee KL, Maurer G, Mokrzycki K, Przybylski R, Roberts BJ, Schaff H, STICH TEE Substudy Investigators, Velazquez EJ, Wrobel K, Yii M
856			_uhttp://dx.doi.org/10.1016/j.amjcard.2013.07.047 _zhttp://dx.doi.org/10.1016/j.amjcard.2013.07.047
942			_cART _dArticle
999			_c1026 _d1026