Zemer Wassercug Noa, Shapira Yaron, Weisenberg Daniel, Monakier Daniel, Bental Tamir, Sagie Alik, Vaturi Mordehay
The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Cardiol. 2015 Jul 1;116(1):121-4. doi: 10.1016/j.amjcard.2015.03.049. Epub 2015 Apr 8.
The aim of this study was to assess the association between mitral annular calcium (MAC) and flail mitral leaflets in a cohort of patients with degenerative mitral valve disease. A retrospective study was conducted of consecutive patients with degenerative mitral valve disease who underwent echocardiography at Rabin Medical Center from 2003 to 2012. Special focus was attended to the presence and grade of MAC and characterization of valve pathology (myxomatous vs nonmyxomatous, prolapse vs flail). Patients were excluded if they had undergone previous mitral valve surgery and/or had infective endocarditis. Multivariate logistic regressions were used to control for confounders. The study included 1,912 patients (60.8% men, mean age 63.8 ± 17.4 years) divided into 3 groups: 1,627 (86%) without MAC, 183 (10%) with either mild or moderate MAC, and 94 (5%) with severe MAC. The presence of flail leaflet was 27%, 30%, and 46% in these groups, respectively (p <0.001). After adjustment for age, gender, and co-morbidities, the odd ratio for flail mitral leaflet with severe MAC versus no MAC was 1.76 (95% confidence interval 1.10 to 2.83, p = 0.019). In conclusion, this study demonstrates that degenerative mitral valve disease with severe MAC is significantly associated with flail mitral leaflet.
本研究的目的是评估退行性二尖瓣疾病患者队列中二尖瓣环钙化（MAC）与连枷样二尖瓣叶之间的关联。对2003年至2012年在拉宾医疗中心接受超声心动图检查的连续退行性二尖瓣疾病患者进行了一项回顾性研究。特别关注MAC的存在情况和分级以及瓣膜病理特征（黏液样变性与非黏液样变性、脱垂与连枷样）。如果患者曾接受过二尖瓣手术和/或患有感染性心内膜炎，则将其排除。采用多变量逻辑回归来控制混杂因素。该研究纳入了1912例患者（男性占60.8%，平均年龄63.8±17.4岁），分为3组：1627例（86%）无MAC，183例（10%）有轻度或中度MAC，94例（5%）有重度MAC。这些组中连枷样瓣叶的发生率分别为27%、30%和46%（p<0.001）。在对年龄、性别和合并症进行调整后，重度MAC患者出现连枷样二尖瓣叶相对于无MAC患者的比值比为1.76（95%置信区间为1.10至2.83，p = 0.019）。总之，本研究表明，伴有重度MAC的退行性二尖瓣疾病与连枷样二尖瓣叶显著相关。
