Patient population
From July 2018 to December 2020, a total of 117 consecutive patients
with degenerative mitral valve disease and significant MR (grade 2+) in
a prospective multicenter study underwent transthoracic and
transesophageal echocardiographic assessment and were included in the
study.
Twenty-three were excluded for the following reasons: (1) 10 were
excluded owning to inadequate echocardiographic image quality for MVN or
3D VCA analysis; (2) 7 were excluded because of with mixed atrial
functional mitral regurgitation or presence of mitral annular
disjunction; (3) 4 were excluded because of significant concomitant
aortic valve disease; (4) 2 was excluded due to having abnormal
segmental wall motion. Twenty subjects (ages 67±8.5) undergoing
clinically indicated TTE and TEE who have no MR with normal left
ventricular (LV) function and mitral apparatus were also examined as
controls. The protocol of this study was approved by the institutional
review board of Zhongshan Hospital and was conducted in accordance with
the Declaration of Helsinki. Written informed consent was obtained at
the time of consent for the clinical TEE procedure in all of the
patients.