Ventricular remodeling and mitral valve modifications in dilated cardiomyopathy: New insights from anatomic study

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http://www.sciencedirect.com/science/article/pii/S002252230200329X

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Conclusion: Differently from what was thought, in ischemic or idiopathic dilated cardiomyopathy, dilation of mitral ring is proportional and does not exclusively affect the posterior portion. The degree of left ventricular dilation does not determine the degree of dilation of the mitral ring because they are independent processes

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Annular Geometry and Motion in Human Ischemic Mitral Regurgitation: Novel Assessment With Three-Dimensional Echocardiography and Computer Reconstruction

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http://www.sciencedirect.com/science/article/pii/S0003497504012457

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Patients with ischemic mitral regurgitation have annular dilatation, with an increase in anterior and posterior annular perimeters; this is accompanied by an increase in the intertrigonal distance and restriction of annular motion.

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Dilatações semelhantes produzem insuficiências desproporcionais. Como a patologia de base, isquemia ou miocardiopatia, afeta o anel mitral parece ser o mais importante.

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Estudos como modalidades diferentes mostram a mesma coisa:

É impossível analisar o refluxo mitral isoladamente pelo Doppler!