Automatic Transesophageal Echocardiographic Evaluation of Patients with Mitral Valve Prolapse: Comparison with Patients Without Structural Cardiac Chamber Remodeling (an exploratory study)

Background: There is a paucity of information concerning automatic mitral valve apparatus analysis of patients with mitral valve prolapse (MVP). We aimed to study with an automatic three-dimensional transesophageal echocardiography (TEE) dedicated software patients with moderate and severe mitral regurgitation when compared to patients with no structural cardiac chamber alterations (patients with patent foramen ovale (PFO) who underwent TEE.

Methods: We employed a TEE software dedicated to automatic analysis of 34 parameters of the mitral valve apparatus comparing MVP patients with moderate and severe mitral regurgitation and patients with PFO without cardiac chamber structural alterations. Mitral valve effective regurgitant orifice (ERO) and regurgitant volume were correlated to automatic MVP parameters.

Conclusions: Automatic mitral valve parameters differed significantly between patients with mitral valve prolapse and those without structural cardiac chamber remodeling. In exploratory analysis, patients in the upper range of ERO values (≥75th percentile) showed patterns involving posterior leaflet geometry that were consistent with the associations observed in continuous-variable analysis. These findings support the potential role of automated three-dimensional assessment in the anatomical characterization of mitral valve prolapse.