Left Atrial Remodeling in Segmental vs. Global Mitral Valve Prolapse　– Three-Dimensional Echocardiography –

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  • Hayashi Atsushi
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Fukuda Shota
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Mahara Keitaro
    Department of Cardiology, Sakakibara Heart Institute
  • Hei Soshi
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Onoue Takeshi
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Kado Yuichiro
    Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine
  • Nagata Yasufumi
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Iwataki Mai
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Otani Kyoko
    Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, School of Medicine
  • Miyamoto Tetsu
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Oginosawa Yasushi
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Sonoda Shinjo
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
  • Eto Masataka
    Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine
  • Nishimura Yosuke
    Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine
  • Takanashi Shuichiro
    Department of Cardiovascular Surgery, Sakakibara Heart Institute
  • Levine Robert A.
    Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School
  • Otsuji Yutaka
    Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine

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<p>Background:Segmental and global mitral valve prolapse (MVP) comprise 2 representative phenotypes in this syndrome. While mitral regurgitation (MR) severity is a major factor causing left atrial (LA) remodeling in MVP, prominent mitral valve (MV) annulus dilatation in global MVP may specifically cause inferiorly predominant LA remodeling. We compared MV annulus and LA geometry in patients with segmental and global MVP.</p><p>Methods and Results:LA volume as well as inferior, middle, and superior LA cross-sectional areas (CSA) were measured on 3-D echocardiography in 20 controls, in 40 patients with segmental MVP, and in 18 with global MVP. On multivariate analysis, MR severity was primarily associated with LA dilatation in segmental MVP (P<0.001), while MV annular dilatation was primarily associated with LA dilatation in global MVP (P<0.001). Although there was no regional predominance in LA dilatation in segmental MVP, inferior predominance of LA dilatation was significant in global MVP (increase in inferior, middle, and superior LA-CSA relative to mean of the controls: +220±70% vs. +171±55% vs. +137±37%, P<0.001).</p><p>Conclusions:LA remodeling in segmental and global MVP is considerably different regarding its association with MR volume or MV annular dilatation and its regional predominance. While MR volume may mainly contribute to LA remodeling in segmental MVP, MV annular dilatation seems to have an important role in LA remodeling in global MVP. (Circ J 2016; 80: 2533–2540)</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 80 (12), 2533-2540, 2016

    一般社団法人 日本循環器学会

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