Abstract
Guidelines suggest using a regurgitant fraction of 50% and regurgitant volume of 60 ml for determination of severe mitral insufficiency. Recent MRI data has suggested that a regurgitant fraction of 40% defines severe primary mitral insufficiency. We sought to determine whether there were gender differences in primary mitral regurgitant volumes for regurgitant fractions of 40% and 50%. A database search identified 394 patients that had MRI with a mitral regurgitant volume ≥ 10 ml or a study indication of mitral insufficiency. Chart review identified 97 patients with primary mitral insufficiency. Of these patients, 53 (54%) were women. Men had significantly larger left ventricular volumes, myocardial mass, stroke volumes and mitral regurgitant volumes (37 ± 25 ml vs. 24 ± 12 ml). The difference in regurgitant fraction between genders was not significant (27 ± 14% vs. 24 ± 11%; p-value = 0.24). Regurgitant fraction and regurgitant volume had a strong linear correlation in both men (r = .95) and women (r = .92). Despite similar linear correlations, the slope-intercept equations differed significantly between men and women (p < .001). A regurgitant fraction of 40% correlated with a regurgitant volume of 59 ml in men and 39.5 ml in women, while a regurgitant fraction of 50% correlated with a regurgitant volume of 76.2 ml in men and 49.6 ml in women. Regurgitant fraction, determined by cardiac MRI, provides a gender independent assessment of primary mitral insufficiency, and suggests that regurgitant volume thresholds for severe primary mitral insufficiency may be lower in women.
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Abbreviations
- MRI:
-
Magnetic resonance imaging
- LVEDV:
-
Left ventricular end-diastolic volume
- LVEDVi:
-
Left ventricular end-diastolic end-systolic volume index
- LVESV:
-
Left ventricular end-systolic volume
- LVESVi:
-
Left ventricular end-systolic volume index
- LVEDD:
-
Left ventricular end-diastolic diameter
- LVESD:
-
Left ventricular end-systolic diameter
- PISA:
-
Proximal isovelocity surface area
- MVP:
-
Mitral valve prolapse
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Acknowledgements
The authors sincerely appreciate the role of each of the following individuals in the cardiac MRI program at Regions Hospital: Sheetal Kaul, MD; Danish Rizvi, MD; Teresa Medo, ARRT; Mike Silvis, BS, ARRT; Melinda Schlegelmilch, ARRT; Nola Sokolwoyak, ARRT; Lorraine Tirrel, ARRT; Emily Johnson, BS, RDCS
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CM House study conception and design, data acquisition and interpretation, drafted the manuscript; M Xi data interpretation and critical manuscript revision; KA Moriarty revised the manuscript and provided final approval; WB Nelson study conception and design, revised the manuscript and provided final approval.
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House, C.M., Xi, M., Moriarty, K.A. et al. Gender differences in primary mitral regurgitant volumes at specific regurgitant fractions as assessed by magnetic resonance imaging. Int J Cardiovasc Imaging 38, 663–671 (2022). https://doi.org/10.1007/s10554-021-02449-z
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DOI: https://doi.org/10.1007/s10554-021-02449-z