Computed Tomography Assessment of the Left Atrium and Left Ventricle as Components of the Mitral Valve Complex in Patients with Functional Mitral Regurgitation: Implications for TMVR Planning

Abstract

Background: Functional mitral regurgitation (FMR) is associated with structural remodeling of the left atrium (LA) and left ventricle (LV). Accurate preprocedural imaging is essential for transcatheter mitral valve replacement (TMVR). The objective of this study was to evaluate LA volume, LV geometry, and LA–LV axis orientation using Multislice CT (MSCT) in patients with FMR compared with healthy controls.
Methods: Fifty subjects underwent contrastenhanced cardiac CT: 25 controls and 25 patients with FMR. LA volume, LV volumes, LV sphericity index, and LA–LV axis angle were assessed and indexed to body surface area.
Results: LA volume index was significantly higher in the FMR group (81 ± 19.8 ml/m²) than in controls (41 ± 9.9 ml/m²; p < 0.0001). The LA–LV axis angle was more obtuse in FMR patients (157.5 ± 6.4° vs. 151 ± 6.4°; p < 0.01). LV remodeling and reduced LVEF were also observed in the FMR cohort.
Conclusion: MSCT provides comprehensive assessment of LA and LV geometry in FMR and supports anatomical evaluation for TMVR planning.