Quantitative Analysis of Mitral Valve Morphology in Mitral Valve Prolapse With Real-Time 3-Dimensional Echocardiography

Autor: Shen Kou Tsai, Wei Hsian Yin, Jen Li Looi, Jeng Wei, Jun Min Xie, Jing Ping Sun, Ivan S. Salgo, Qing Shan Lin, Alex Pui-Wai Lee, Fang Fang, Song Wan, Ming C. Hsiung, Malcolm J. Underwood, Cheuk-Man Yu, Randolph H.L. Wong, Yan Chao Zhang
Rok vydání: 2013
Předmět:
Zdroj: Circulation. 127:832-841
ISSN: 1524-4539
0009-7322
DOI: 10.1161/circulationaha.112.118083
Popis: Background— Few data exist on the relation of the 3-dimensional morphology of mitral valve and degree of mitral regurgitation (MR) in mitral valve prolapse. Methods and Results— Real-time 3-dimensional transesophageal echocardiography of the mitral valve was acquired in 112 subjects, including 36 patients with mitral valve prolapse and significant MR (≥3+; MR+ group), 32 patients with mitral valve prolapse but no or mild MR (≤2+; MR− group), 12 patients with significant MR resulting from nonprolapse pathologies (nonprolapse group), and 32 control subjects. The 3-dimensional geometry of mitral valve apparatus was measured with dedicated quantification software. Compared with the normal and MR− groups, the MR+ group had more dilated mitral annulus ( P P P P P P P 20%, 15%–20%, and P =0.004). Leaflet billow volume increased exponentially with decreasing AHCWR in patients without chordal rupture ( r 2 =0.66, P r 2 =0.74, P r 2 =0.44, P P =0.0004) was strongly associated with significant MR in mitral valve prolapse. Conclusion— Flattening of the annular saddle shape is associated with progressive leaflet billowing and increased frequencies of chordal rupture and may be important in the pathogenesis of MR in mitral valve prolapse.
Databáze: OpenAIRE