Basal Left Ventricular Dilatation and Reduced Contraction in Patients With Mitral Valve Prolapse Can Be Secondary to Annular Dilatation: Preoperative and Postoperative Speckle-Tracking Echocardiographic Study on Left Ventricle and Mitral Valve Annulus Interaction.

Autor:	Fukuda S; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Song JK; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Mahara K; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Kuwaki H; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Jang JY; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Takeuchi M; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Sun BJ; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Kim YJ; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Miyamoto T; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Oginosawa Y; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Sonoda S; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Eto M; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Nishimura Y; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Takanashi S; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Levine RA; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.)., Otsuji Y; From the Second Department of Internal Medicine (S.F., H.K., T.M., Y.O., S.S., Y.O.), Departments of Laboratory and Transfusion Medicine (M.T.), and Cardiovascular Surgery (M.E., Y.N.), University of Occupational and Environmental Health, Kitakyushu, Japan; Cardiac Imaging Center, Asan Medical Center Heart Institute, Seoul, South Korea (J.-K.S., J.Y.J., B.J.S., J.K.); Departments of Cardiology (K.M., S.T.) and Cardiovascular Surgery (K.M., S.T.), Sakakibara Heart Institute, Fuchu, Japan; and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston (R.A.L.). otsujiy@med.uoeh-u.ac.jp.
Jazyk:	angličtina
Zdroj:	Circulation. Cardiovascular imaging [Circ Cardiovasc Imaging] 2016 Oct; Vol. 9 (10).
DOI:	10.1161/CIRCIMAGING.115.005113
Abstrakt:	Background: Prominent mitral valve (MV) annular dilatation with only modest left ventricular (LV) dilatation in patients with MV prolapse (MVP) suggests predominant dilatation in adjacent basal LV, which may augment regional wall tension and attenuate contraction by Laplace's law. We hypothesized that MV annular dilatation in patients with MVP is associated with the basal predominance of LV dilatation and attenuated contraction, which can be altered by surgical MV plasty with annulus reduction. Methods and Results: Echocardiography with speckle-tracking analysis to assess regional cross-sectional short-axis area and longitudinal contraction (strain) of basal, middle, and apical LV was performed in 30 controls and 130 patients with MVP. The basal value/averaged middle and apical values (B/M·A ratio) of LV cross-sectional area and strain were obtained. Patients with MVP showed significantly greater MV annular area (6.4±1.6 versus 3.7±0.6 cm 2 /m 2 ), increased B/M·A LV area ratio (2.4±0.5 versus 1.8±0.2), and reduced B/M·A LV strain ratio (0.83±0.14 versus 0.96±0.09) than controls (P<0.001). Multivariable analyses identified that MV annular dilatation was independently associated with increased B/M·A LV area ratio (β=0.60, P<0.001), which was associated with reduced B/M·A LV strain ratio (β=-0.32, P<0.001). In 35 patients with MVP, B/M·A LV area and strain ratio significantly altered after surgical MV plasty with annulus reduction (2.5±0.5-1.8±0.3 and 0.73±0.10-0.89±0.17, P<0.001, respectively). Conclusions: In patients with MVP, MV annular dilatation was associated with the basal predominance of LV dilatation and reduced contraction, which can be altered by surgical MV plasty with annulus reduction, suggesting unfavorable influence from MV annular dilatation on basal LV. (© 2016 American Heart Association, Inc.)
Databáze:	MEDLINE
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