Relation of mitral valve morphology and motion to mitral regurgitation severity in patients with mitral valve prolapse

Cardiovascular Ultrasound

Research

Christian Couture¹  Michelle Dubois²  Mathieu Bernier²  Nicolas Michaud²  Jimmy MacHaalany²  Julien Magne²  Olivier F Bertrand²  Mario Sénéchal²  Pierre Voisine³  Patrick Mathieu³ 

[1] Department of Anatomo-pathology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Chemin Sainte-Foy, G1V 4G5, Quebec, Canada;Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Chemin Sainte-Foy, G1V 4G5, Quebec, Canada;Department of Cardiovascular Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Chemin Sainte-Foy, G1V 4G5, Quebec, Canada;

关键词: mitral regurgitation;    mitral valve;    echocardiography;    mitral valve prolapse;   

DOI  :  10.1186/1476-7120-10-3

 received in 2011-08-03, accepted in 2012-01-27,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundMitral valve thickness is used as a criterion to distinguish the classical from the non-classical form of mitral valve prolapse (MVP). Classical form of MVP has been associated with higher risk of mitral regurgitation (MR) and concomitant complications. We sought to determine the relation of mitral valve morphology and motion to mitral regurgitation severity in patients with MVP.MethodsWe prospectively analyzed transthoracic echocardiograms of 38 consecutive patients with MVP and various degrees of MR. In the parasternal long-axis view, leaflets length, diastolic leaflet thickness, prolapsing depth, billowing area and non-coaptation distance between both leaflets were measured.ResultsTwenty patients (53%) and 18 patients (47%) were identified as having moderate to severe and mild MR respectively (ERO = 45 ± 27 mm2 vs. 5 ± 7 mm2, p < 0.001). Diastolic leaflet thickness was similar in both groups (5.5 ± 0.9 mm vs. 5.3 ± 1 mm, p = 0.57). On multivariate analysis, the non-coaptation distance (OR 7.9 per 1 mm increase; 95% CI 1.72-37.2) was associated with significant MR. Thick mitral valve leaflet as traditionally reported (≥ 5 mm) was not associated with significant MR (OR 0.9; 95% CI 0.2-3.4).ConclusionsIn patients with MVP, thick mitral leaflet is not associated with significant MR. Leaflet thickness is probably not as important in risk stratification as previously reported in patients with MVP. Other anatomical and geometrical features of the mitral valve apparatus area appear to be much more closely related to MR severity.

【 授权许可】

CC BY   
© Sénéchal et al; licensee BioMed Central Ltd. 2012