Relations of Augmented Systolic Annular Expansion and Leaflet/Papillary Muscle Dynamics in Late-Systolic Mitral Valve Prolapse Evaluated by Echocardiography with a Speckle Tracking Analysis
-
- Hei Soshi
- 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
-
- Jang Jeong-Yoon
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine
-
- Kuwaki Hiroshi
- 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
-
- Kim Yun-Jeong
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine
-
- Toki Misako
- Department of Clinical Laboratory, The Sakakibara Heart Institute of Okayama
-
- Onoue Takeshi
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
-
- Hayashi Atsushi
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
-
- Nishino Shun
- Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center
-
- Watanabe Nozomi
- Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center
-
- Hayashida Akihiro
- Department of Cardiology, The Sakakibara Heart Institute of Okayama
-
- Tsuda Yuki
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
-
- Araki Masaru
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
-
- Nishimura Yosuke
- Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine
-
- Song Jae-Kwan
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine
-
- Yoshida Kiyoshi
- Department of Cardiology, The Sakakibara Heart Institute of Okayama
-
- 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
Search this article
Abstract
<p>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.</p><p>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.</p><p>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/m2, 2.5 ± 1.4 versus 0.6 ± 2.0 mm/m2, 6.8 ± 2.5 versus 5.7 ± 1.0 cm2/m2 and 1.6 ± 0.8 versus 0.1 ± 0.5 cm2/m2, P < 0.001, respectively). Multivariate analysis identified MV leaflets' lengthening and PMs' superior shift as independent factors associated with MV annular expansion.</p><p>Conclusions: These results suggest that systolic MV annular expansion in MVP is related to abnormal MV leaflets' lengthening and PMs' superior shift.</p>
Journal
-
- International Heart Journal
-
International Heart Journal 61 (5), 970-978, 2020-09-29
International Heart Journal Association
