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退行性二尖瓣狭窄的患病率及临床特征

Prevalence and clinical characteristics of degenerative mitral stenosis.

作者信息

Ukita Yasuyuki, Yuda Satoshi, Sugio Hideaki, Yonezawa Ayaka, Takayanagi Yuka, Masuda-Yamamoto Hitomi, Tanaka-Saito Norie, Ohnishi Hirofumi, Miura Tetsuji

机构信息

Department of Clinical Laboratory, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan.

Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.

出版信息

J Cardiol. 2016 Sep;68(3):248-52. doi: 10.1016/j.jjcc.2015.09.021. Epub 2015 Nov 3.

Abstract

BACKGROUND

Degenerative mitral stenosis (DMS) is found in the elderly population. However, there are a few reports regarding the prevalence rate of DMS and, its clinical characteristics. The aim of this study was to determine the relationship between age, gender, and the prevalence rate of DMS.

METHODS

Patients with DMS and rheumatic mitral stenosis (RMS) were searched retrospectively in consecutive patients who underwent echocardiography from January 2011 to December 2013 in a community hospital. DMS was defined as presence of both turbulent antegrade flow with a mean transmitral pressure gradient (PG) of ≥2mmHg and mitral annular calcification without restriction of leaflets tip motion.

RESULTS

We identified 19 patients (17 female and 2 male) with DMS (0.22%) and 19 patients with RMS in 8683 patients. The prevalence rate of DMS significantly increased with aging, especially in patients >90 years old. There was no significant difference in the prevalence rates of RMS among the age groups. Patients with DMS were older (86±8 years vs. 73±10 years, p<0.01) and had higher rates of hypertension and aortic stenosis, larger left ventricular mass index, and mean PG of aortic valve, smaller aortic valve area, less degree of left atrial dilatation, and lower rate of atrial fibrillation, compared with those values in patients with RMS.

CONCLUSIONS

DMS is rare (0.22%) and almost exclusively found in females in routine echocardiography. The prevalence of DMS increases with aging to 2.5% in patients >90 years of age, and DMS is often associated with aortic valve stenosis.

摘要

背景

退行性二尖瓣狭窄(DMS)多见于老年人群。然而,关于DMS的患病率及其临床特征的报道较少。本研究的目的是确定年龄、性别与DMS患病率之间的关系。

方法

回顾性检索2011年1月至2013年12月在一家社区医院接受超声心动图检查的连续患者中患有DMS和风湿性二尖瓣狭窄(RMS)的患者。DMS的定义为存在平均二尖瓣跨瓣压差(PG)≥2mmHg的湍流前向血流以及二尖瓣环钙化且瓣叶尖端运动无受限。

结果

在8683例患者中,我们确定了19例(17例女性和2例男性)患有DMS(0.22%)以及19例患有RMS的患者。DMS的患病率随年龄增长显著增加,尤其是在90岁以上的患者中。各年龄组RMS的患病率无显著差异。与RMS患者相比,DMS患者年龄更大(86±8岁 vs. 73±10岁,p<0.01),高血压和主动脉瓣狭窄的发生率更高,左心室质量指数更大,主动脉瓣平均PG更高,主动脉瓣面积更小,左心房扩张程度更低,房颤发生率更低。

结论

DMS罕见(0.22%),在常规超声心动图检查中几乎仅见于女性。DMS的患病率随年龄增长而增加,在90岁以上患者中达2.5%,且DMS常与主动脉瓣狭窄相关。

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