ニシムラ ヨウスケ   Nishimura Yosuke
  西村 陽介
   所属   医学部医学科  臨床医学系 心臓血管外科学
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 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.
掲載誌名 正式名:Circulation. Cardiovascular imaging
略  称:Circ Cardiovasc Imaging
ISSNコード:19420080/19419651
掲載区分国外
巻・号・頁 9(10),e005113--頁
著者・共著者 Fukuda Shota, Song Jae-Kwan, Mahara Keitaro, Kuwaki Hiroshi, Jang Jeong Yoon, Takeuchi Masaaki, Sun Byung Joo, Kim Yun Jeong, Miyamoto Tetsu, Oginosawa Yasushi, Sonoda Shinjo, Eto Masataka, Nishimura Yosuke, Takanashi Shuichiro, Levine Robert A, Otsuji Yutaka
発行年月 2016/10
概要 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.
DOI 10.1161/CIRCIMAGING.115.005113
PMID 27729364