Mitral and tricuspid annuli in hemophilia—A detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

Aim: Hypocoagulability and associated alterations in myocardial mechanics seen in hemophilia could theoretically impact valvular geometry. Therefore, the purpose of the present study was to characterize mitral and tricuspid annular dimensions and functions in patients with hemophilia via 3D speckle-tracking echocardiography. Methods: Of the 17 hemophilia patients originally assessed, four were excluded due to inadequate image quality. The remaining cohort consisted of 13 males with hemophilia (mean age: 40.8 ± 16.3 years; 11 with hemophilia A and 2 with hemophilia B). Thirty age- and gender-matched healthy males (mean age: 40.4 ± 9.2 years) served as the control group. Results: Hemophilia patients presented with significant dilation of end-diastolic and end-systolic mitral annulus (MA) dimensions (diameter, area, and perimeter), leading to a reduction in MA fractional area change (MAFAC) compared with control subjects. In contrast, among the tricuspid annulus (TA) parameters, dilation was confined to end-diastolic values, while end-systolic dimensions were preserved. Conclusions: Dilated MA, along with its functional deterioration, is present in patients with hemophilia compared to matched controls. TA dilation seems less pronounced.