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Morphofunctional features of the mitral complex against the background of aortic root aneurysm

Authors: Aydamirova E.K., Brovich K.N., Klimchuk I.Ya., Mironenko M.Yu., Mironenko V.A., Minaev A.V.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2026-20-2-267-281

For citation: Aydamirova E.K., Brovich K.N., Klimchuk I.Ya., Mironenko M.Yu., Mironenko V.A., Minaev A.V. Morphofunctional features of the mitral complex against the background of aortic root aneurysm. Creative Cardiology. 2026; 20 (2): 267–281 (in Russ.). DOI: 10.24022/1997-3187-2026-20-2-267-281

Received / Accepted:  02.04.2026 / 12.05.2026

Keywords: mitral valve aortic root fibrous mitral-aortic junction functional mitral regurgitation three-dimensional echocardiography morphometric parameters of the mitral complex



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Abstract

Objective. To study the geometry of the mitral complex in patients with functional mitral regurgitation against the background of aortic root aneurysm (ARA).

Material and methods. The study included 42 patients (76.2% male, median age 54 years) with aortic root aneurysm and concomitant mitral and aortic regurgitation of at least moderate severity. The size of the aortic root was Me = 55 (44; 60) mm. Statistical analysis was performed using descriptive statistics, correlation analysis (Pearson’s and Spearman’s criteria), and piecewise linear regression to construct prognostic models.

Results. The analysis revealed a direct noticeable correlation between aortic root (AR) and the area of the fibrous ring (FR) of the mitral valve (MV) (R2 = 0.55), the FR of the aortic valve (AV) (R2 = 0.50); a noticeable direct correlation between AR and the perimeter (R2 = 0.66), the area of the MR FR (R2 = 0.61), the length of the anterior mitral leaflet (AML) (R2 = 0.60), and the angle of the posterior mitral leaflet (PML) (R2 = 0.63); high direct correlation of the ascending aorta (AA) with the area of the AML (R2 = 0.78) and high inverse correlations with height (R2 = –0.73) and prolapse volume (R2 = –0.71). The AV FR had a significant positive correlation with the interpapillary distance (R2 = 0.61), a moderate positive correlation with the size of the AA (R2 = 0.45), and a significant negative correlation with the mitral-aortic angle (R2 = –0.55). This angle had a significant positive correlation with the intercommissural distance (R2 = 0.67) and the FR area in the projection plane (R2 = 0.51). A piecewise linear regression analysis revealed the morphometric parameters of the mitral complex and left ventricle that are most susceptible to the effects of aortic root dilatation.

Conclusion. The mitral complex in aortic root aneurysm has specific morphometric changes. The developed models have a high ability to predict the degree of remodeling of the MV and left ventricle (LV) based on preoperative measurements of the aorta.

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About Authors

  • Eset K. Aydamirova, Resident Physician; ORCID
  • Kseniya N. Brovich, Cardiologist; ORCID
  • Igor Ya. Klimchuk, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
  • Marina Yu. Mironenko, Dr. Med. Sci., Head of Department; ORCID
  • Vladimir A. Mironenko, Dr. Med. Sci., Deputy Director for Adult Cardiac Surgery, Head of Department, Cardiovascular Surgeon; ORCID
  • Anton V. Minaev, Dr. Med. Sci., Senior Researcher, Cardiovascular Surgeon; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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