Figure 2.

Impaired leaflet coaptation can be enhanced by dyssynchronous contraction of left ventricle basal segments, that may cause a papillary muscles asynchronous contraction. A: 2D radial strain of a papillary muscles short axis in a patient with functional MR; B: During systole, myocardial segments adjacent to postero-medial papillary muscles (red and blue segments) show negative radial strain values, whereas antero-lateral papillary muscles (light blue and green segments) show a positive strain values, resulting in a significant papillary dyssynchrony. 2D: 2 dimensional; MR: Magnetic resonance.