Interstitial Collagen Loss, Myocardial Remodeling, and Function in Primary Mitral Regurgitation

Mustafa I Ahmed; Efstathia Andrikopoulou; Jingyi Zheng; Elena Ulasova; Betty Pat; Eric E Kelley; Pamela Cox Powell; Thomas S Denney Jr; Clifton Lewis; James E Davies; Victor Darley-Usmar; Louis J Dell'Italia

doi:10.1016/j.jacbts.2022.04.014

Interstitial Collagen Loss, Myocardial Remodeling, and Function in Primary Mitral Regurgitation

JACC Basic Transl Sci. 2022 Sep 14;7(10):973-981. doi: 10.1016/j.jacbts.2022.04.014. eCollection 2022 Oct.

Authors

Mustafa I Ahmed¹, Efstathia Andrikopoulou¹, Jingyi Zheng², Elena Ulasova³, Betty Pat^{1

4}, Eric E Kelley⁵, Pamela Cox Powell^{1

4}, Thomas S Denney Jr⁶, Clifton Lewis⁷, James E Davies⁷, Victor Darley-Usmar³, Louis J Dell'Italia^{1

4}

Affiliations

¹ Division of Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
² Department of Mathematics and Statistics, Auburn University, Auburn, Alabama, USA.
³ Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁴ Birmingham Veterans Affairs Health Care System, Birmingham, Alabama, USA.
⁵ Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia, USA.
⁶ Samuel Ginn College of Engineering, Auburn University, Auburn, Alabama, USA.
⁷ Division of Thoracic and Cardiovascular Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Abstract

Interstitial collagen loss and cardiomyocyte ultrastructural damage accounts for left ventricular (LV) sphericity and decrease in LV twist and circumferential strain. Normal LV diastolic function belies significantly abnormal left atrial (LA) function and early LV diastolic untwist rate. This underscores the complex interplay of LV and LA myocardial remodeling and function in the pathophysiology of primary mitral regurgitation. In this study, we connect LA function with LV systolic and diastolic myocardial remodeling and function using cardiac magnetic resonance tissue tagging in primary mitral regurgitation.

Keywords: BNP, brain natriuretic peptide; CMR, cardiac magnetic resonance; ED, end diastole; ES, end systole; ICTP, carboxy-terminal telopeptide of collagen type I; LA, left atrial; LV, left ventricle; LVEF, LV ejection fraction; PICP, carboxy-terminal propeptide of procollagen type I; PMR, primary mitral regurgitation; RV, right ventricle; SV, stroke volume; XO, xanthine oxidase; cardiac magnetic resonance; collagen loss; left ventricular remodeling; primary mitral regurgitation.