Importance of mitral valve second-order chordae for left ventricular geometry, wall thickening mechanics, and global systolic function

Filiberto Rodriguez, Frank Langer, Katherine B. Harrington, Frederick (Fred) Tibayan, Mary K. Zasio, Allen Cheng, David Liang, George T. Daughters, James W. Covell, John C. Criscione, Neil B. Ingels, D. Craig Miller

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74 Scopus citations

Abstract

Background-Mitral valvular-ventricular continuity is important for left ventricular (LV) systolic function, but the specific contributions of the anterior leaflet second-order "strut" chordae are unknown. Methods and Results-Eight sheep had radiopaque markers implanted to silhouette the LV, annulus, and papillary muscles (PMs); 3 transmural bead columns were inserted into the mid-lateral wall between the PMs. The strut chordae were encircled with exteriorized wire snares. Three-dimensional marker images and hemodynamic data were acquired before and after chordal cutting. Preload recruitable stroke work (PRSW) and end-systolic elastance (Ees) were calculated to assess global LV systolic function (n = 7). Transmural strains were measured from bead displacements (n=4). Chordal cutting caused global LV dysfunction: E es (1.48∓1.12 versus 0.98±1.30 mm Hg/mL, P=0.04) and PRSW (69±16 versus 60±15 mm Hg, P=0.03) decreased. Although heart rate and time from ED to ES were unchanged, time of mid-ejection was delayed (125±18 versus 136±19 ms, P=001). Globally, the LV apex and posterior PM tip were displaced away from the fibrous annulus and LV base-apex length increased at end-diastole and end-systole (all +1 mm, P12) 0.030±0.013 and radial thickening (E33) 0.081±0.041 (both P12) (0.099±0.035 versus 0.075±0.025) and circumferential radial shear (E13) (0.084±0.023 versus 0.039±0.008, both P

Original languageEnglish (US)
JournalCirculation
Volume110
Issue number11 SUPPL.
DOIs
StatePublished - Sep 14 2004
Externally publishedYes

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Keywords

  • Contractility
  • Mechanics
  • Mitral valve
  • Regurgitation
  • Structure

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Rodriguez, F., Langer, F., Harrington, K. B., Tibayan, F. F., Zasio, M. K., Cheng, A., Liang, D., Daughters, G. T., Covell, J. W., Criscione, J. C., Ingels, N. B., & Miller, D. C. (2004). Importance of mitral valve second-order chordae for left ventricular geometry, wall thickening mechanics, and global systolic function. Circulation, 110(11 SUPPL.). https://doi.org/10.1161/01.CIR.0000138580.57971.b4