| Autor: |
Hei S; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Iwataki M; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Jang JY; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine., Kuwaki H; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Fukuda S; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Kim YJ; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine., Toki M; Department of Clinical Laboratory, The Sakakibara Heart Institute of Okayama., Onoue T; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Hayashi A; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Nishino S; Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center., Watanabe N; Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center., Hayashida A; Department of Cardiology, The Sakakibara Heart Institute of Okayama., Tsuda Y; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Araki M; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine., Nishimura Y; Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine., Song JK; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine., Yoshida K; Department of Cardiology, The Sakakibara Heart Institute of Okayama., Levine RA; Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School., Otsuji Y; Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine. |
| Abstrakt: |
The mechanism of systolic annular expansion in mitral valve prolapse (MVP) is not clarified. Since annular expansion is systolic outward shift of MV leaflet/chorda tissue complex at superior and outer ends, annular expansion could be related to inward (superior) shift of the complex at another inferior and inner end of the papillary muscle (PM) tip and/or systolic lengthening of the tissue complex, especially MV leaflets.MV annulus systolic expansion, PMs' systolic superior shift, and MV leaflets' systolic lengthening were evaluated by echocardiography with a speckle tracking analysis in 25 normal subjects, 25 subjects with holo-systolic MVP and 20 subjects with late-systolic MVP.PMs' superior shift, MV leaflets' lengthening, MV annular area at the onset of systole and subsequent MV annulus expansion were significantly greater in late-systolic MVP than in holo-systolic MVP (4.6 ± 1.6 versus 1.5 ± 0.7 mm/m 2 , 2.5 ± 1.4 versus 0.6 ± 2.0 mm/m 2 , 6.8 ± 2.5 versus 5.7 ± 1.0 cm 2 /m 2 and 1.6 ± 0.8 versus 0.1 ± 0.5 cm 2 /m 2 , P < 0.001, respectively). Multivariate analysis identified MV leaflets' lengthening and PMs' superior shift as independent factors associated with MV annular expansion.Conclusions: These results suggest that systolic MV annular expansion in MVP is related to abnormal MV leaflets' lengthening and PMs' superior shift. |
