Early Right Heart Remodeling in Patients With Mitral Valve Prolapse

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2024-10-30 DOI:10.1111/echo.70017

Dario Donia, Kamil Stankowski, Federica Testerini, Martina Ruffo, Lorenzo Cambini, Silvana Di Maio, Riccardo Mantovani, Carlo A. Pivato, Carlo M. Dellino, Giulio G. Stefanini, Renato Maria Bragato, Gianluigi Condorelli, Stefano Figliozzi

{"title":"Early Right Heart Remodeling in Patients With Mitral Valve Prolapse","authors":"Dario Donia, Kamil Stankowski, Federica Testerini, Martina Ruffo, Lorenzo Cambini, Silvana Di Maio, Riccardo Mantovani, Carlo A. Pivato, Carlo M. Dellino, Giulio G. Stefanini, Renato Maria Bragato, Gianluigi Condorelli, Stefano Figliozzi","doi":"10.1111/echo.70017","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Mitral valve prolapse (MVP) has been associated with left heart remodeling. This study explored cardiac remodeling in patients with MVP without significant regurgitation, focusing on the right heart.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This single-center study enrolled consecutive patients referred to trans-thoracic-echocardiography (TTE) with MVP, excluding those with significant regurgitation or known cardiovascular or pulmonary diseases. A group of healthy controls was included.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Forty-nine patients with MVP and 54 controls were finally selected (mean age of 62, 52–71; 52% males), and echocardiographic parameters were compared among groups. Twenty-nine (41%) patients with MVP showed tricuspid valve prolapse (TVP). Patients with MVP, irrespective of TVP, showed greater tricuspid annulus (systolic annulus: 31±6 vs. 32±5 vs. 27±3 mm for MVP<sup>+</sup>/TVP<sup>−</sup>, MVP<sup>+</sup>/TVP<sup>+</sup>, and controls, respectively; all <i>p</i> < 0.01) and greater minimum right atrial volume indexed (13, 12–15 mL/m<sup>2</sup> vs. 15, 12–20 mL/m<sup>2</sup> vs. 11, 10–14 mL/m<sup>2</sup>; all <i>p</i> < 0.05). Right ventricular dimensions and systolic indexes did not differ among groups, except TAPSE, which was significantly greater in MVP<sup>+</sup>/TVP<sup>+</sup> patients compared to controls (25±4 vs. 22±3 mm, <i>p</i> = 0.004). A significant correlation (<i>ρ</i> = 0.43; <i>p</i> < 0.001) and an independent association at multivariate analysis (<i>ß</i> = 0.28; 95% CI 0.09–0.47; <i>p</i> = 0.004) were observed between end-systolic tricuspid diameter and TAPSE.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In patients with MVP with less-than-moderate mitral or tricuspid regurgitation, dilation of the right atrium and tricuspid annulus was found. The latter finding was associated with increased values of TAPSE, which should then be used with caution, while other indexes may be preferred when assessing the systolic function of these patients.</p>\n </section>\n </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70017","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/echo.70017","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Mitral valve prolapse (MVP) has been associated with left heart remodeling. This study explored cardiac remodeling in patients with MVP without significant regurgitation, focusing on the right heart.

Methods

This single-center study enrolled consecutive patients referred to trans-thoracic-echocardiography (TTE) with MVP, excluding those with significant regurgitation or known cardiovascular or pulmonary diseases. A group of healthy controls was included.

Results

Forty-nine patients with MVP and 54 controls were finally selected (mean age of 62, 52–71; 52% males), and echocardiographic parameters were compared among groups. Twenty-nine (41%) patients with MVP showed tricuspid valve prolapse (TVP). Patients with MVP, irrespective of TVP, showed greater tricuspid annulus (systolic annulus: 31±6 vs. 32±5 vs. 27±3 mm for MVP⁺/TVP⁻, MVP⁺/TVP⁺, and controls, respectively; all p < 0.01) and greater minimum right atrial volume indexed (13, 12–15 mL/m² vs. 15, 12–20 mL/m² vs. 11, 10–14 mL/m²; all p < 0.05). Right ventricular dimensions and systolic indexes did not differ among groups, except TAPSE, which was significantly greater in MVP⁺/TVP⁺ patients compared to controls (25±4 vs. 22±3 mm, p = 0.004). A significant correlation (ρ = 0.43; p < 0.001) and an independent association at multivariate analysis (ß = 0.28; 95% CI 0.09–0.47; p = 0.004) were observed between end-systolic tricuspid diameter and TAPSE.

Conclusion

In patients with MVP with less-than-moderate mitral or tricuspid regurgitation, dilation of the right atrium and tricuspid annulus was found. The latter finding was associated with increased values of TAPSE, which should then be used with caution, while other indexes may be preferred when assessing the systolic function of these patients.

Abstract Image

查看原文本刊更多论文

二尖瓣脱垂患者的早期右心重塑

目的：二尖瓣脱垂（MVP）与左心重塑有关。本研究探讨了无明显反流的二尖瓣脱垂患者的心脏重塑情况，重点关注右心：这项单中心研究招募了连续接受经胸超声心动图（TTE）检查的 MVP 患者，排除了有明显反流或已知心血管或肺部疾病的患者。结果：最终选出 49 名 MVP 患者和 54 名对照组患者（平均年龄 62 岁，52-71 岁；52% 为男性），并比较了各组的超声心动图参数。29 名 MVP 患者（41%）显示三尖瓣脱垂（TVP）。MVP 患者，无论 TVP 与否，三尖瓣环均较大（MVP+/TVP-、MVP+/TVP+ 和对照组的收缩期三尖瓣环分别为 31±6 vs. 32±5 vs. 27±3 mm；均 p <0.01），右心房最小容积指数较大（13、12-15 mL/m2 vs. 15、12-20 mL/m2 vs. 11、10-14 mL/m2；均 p <0.05）。除 TAPSE 外，各组间的右心室尺寸和收缩指数没有差异，MVP+/TVP+ 患者的 TAPSE 明显高于对照组（25±4 mm vs. 22±3 mm，P = 0.004）。收缩末期三尖瓣直径与 TAPSE 之间存在明显的相关性（ρ = 0.43; p < 0.001），并且在多变量分析中存在独立的关联性（ß = 0.28; 95% CI 0.09-0.47; p = 0.004）：结论：在二尖瓣或三尖瓣反流不严重的 MVP 患者中，发现右心房和三尖瓣环扩张。结论：在二尖瓣或三尖瓣反流不太严重的 MVP 患者中，发现右心房和三尖瓣环扩张，后一发现与 TAPSE 值升高有关，因此在评估这些患者的收缩功能时，应谨慎使用 TAPSE，而首选其他指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.