Preoperative assessment of mitral valve abnormalities in left atrial myxoma patients using cardiac CT

// Jing Chen 1,3,* , Zhi-Gang Yang 1 , En-Sen Ma 4,* , Qin Zhang 1 , Xi Liu 1 and Ying-Kun Guo 2 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China 2 Department of Radiology, West China Second University Hospital, Sichuan University, China 3 Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China 4 Department of Radiology, China–Japan Friendship Hospital, Yinghua Dongjie, Chaoyang, Beijing, China * These authors have contributed equally to this work and should be considered co-first authors Correspondence to: Zhi-Gang Yang, email: // Ying-Kun Guo, email: // Keywords : cardiac myxoma, dual-source CT, mitral valve, mitral regurgitation, mitral stenosis Received : January 05, 2017 Accepted : February 13, 2017 Published : March 11, 2017 Abstract Background: To retrospectively evaluate mitral valve abnormality in left atrial myxoma patients by using cardiac computed tomography (CT). Material and methods: Cardiac CT was performed in 56 patients with left atrial myxoma and 50 controls. Tumor and mitral valve characteristics were analyzed. The mitral valve parameters differences were compared between patients with myxoma and controls, myxoma with or without mitral valve obstruction, different obstruction degrees, respectively. Receiver operating characteristic analysis was performed to determine the cut-off values of abnormal mitral valve parameters for myxoma patients. Multiple linear regression, logistic regression models and cox regression analysis were used to determine factors associated with mitral valve abnormalities, mitral obstruction, mitral regurgitation and postoperative recovery, respectively. Results: Myxoma induced the dilation of mitral valve, with different results among different degrees of obstruction ( p <0.001). Mitral valve parameters had relationship with myxoma parameters. The cut-off values for discriminating mitral valve abnormalities in myxoma patients were found. Some significant predictors for mitral obstruction were tumor pedicle-tumor volume and patient age (HR, 0.886-30.811; p = 0.011-0.043). Moreover, the predictor for mitral regurgitation was mitral annulus diameter in diastolic phase (HR, 20.862; 95%CI,1.331-327.100; p = 0.031). Some predictors associated with postoperative recovery of mitral regurgitation were age, mitral annulus area, mitral annulus diameter and mitral valve diameter cutoff value for diastolic phase (HR, 0.001-119.160; p = 0.012-0.028). Conclusion: Cardiac CT is capable of quantitatively assessing myxoma characteristic and mitral valve abnormality induced by myxoma, thus providing guidance of operative management and postoperative evaluation.