Nishimura Yosuke
   Department   School of Medicine  Cardiovascular Surgery, Clinical Medical Sciences
Article types journal article
Language English
Peer review Peer reviewed
Title Left Atrial Remodeling in Segmental vs. Global Mitral Valve Prolapse - Three-Dimensional Echocardiography.
Journal Formal name:Circulation journal : official journal of the Japanese Circulation Society
Abbreviation:Circ J
ISSN code:13474820/13469843
Volume, Issue, Page 80(12),2533-2540頁
Author and coauthor Hayashi Atsushi, Fukuda Shota, Mahara Keitaro, Hei Soshi, Onoue Takeshi, Kado Yuichiro, Nagata Yasufumi, Iwataki Mai, Otani Kyoko, Miyamoto Tetsu, Oginosawa Yasushi, Sonoda Shinjo, Eto Masataka, Nishimura Yosuke, Takanashi Shuichiro, Levine Robert A, Otsuji Yutaka
Publication date 2016/11
Summary 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.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).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).
DOI 10.1253/circj.CJ-16-0694
PMID 27829586