Department of Clinical Laboratory, The University of Tokyo Hospital.
Department of Cardiovascular Medicine, The University of Tokyo Hospital.
Int Heart J. 2021 Jan 30;62(1):95-103. doi: 10.1536/ihj.20-148. Epub 2021 Jan 16.
Enlargement of the mitral valve (MV) has gained attention as a compensatory mechanism for functional mitral regurgitation (FMR). We aimed to determine if MV leaflet area is associated with MV coaptation-zone area and identify the clinical factors associated with MV leaflet size and coaptation-zone area in patients with normal left ventricle (LV) systolic function and size using real-time 3D echocardiography (RT3DE).We performed RT3DE in 135 patients with normal LV size and ejection fraction. MV leaflet and coaptation-zone areas were measured using custom 3D software. The clinical factors associated with MV leaflet and coaptation-zone areas were evaluated using univariate and multivariate linear regression analyses.There was a significant relationship between MV leaflet and coaptation-zone areas (r = 0.499, P < 0.001). MV leaflet area was strongly associated with body surface area (BSA) (r = 0.905, P < 0.001) rather than LV size and age. MV leaflet area/BSA was independently associated with male gender (P = 0.002), lower diastolic blood pressure (P = 0.042), and LV end-diastolic volume (LVEDV) index (P = 0.048); MV coaptation-zone area/BSA was independently associated with lower LVEDV index (P = 0.01).In patients with normal LV systolic function and size, MV leaflet size has a significant impact on competent MV coaptation. MV leaflet area might be intrinsically determined by body size rather than age and LV size, and the MV leaflet area/BSA is relatively constant. On the other hand, some clinical factors might also influence MV leaflet and coaptation-zone area.
二尖瓣（MV）扩大已成为功能性二尖瓣反流（FMR）的代偿机制而受到关注。我们旨在通过实时 3 维超声心动图（RT3DE）确定 MV 瓣叶面积是否与 MV 对合区面积相关，并确定左心室（LV）收缩功能和大小正常的患者中与 MV 瓣叶大小和对合区面积相关的临床因素。我们对 135 例 LV 大小和射血分数正常的患者进行了 RT3DE。使用定制的 3D 软件测量 MV 瓣叶和对合区面积。使用单变量和多变量线性回归分析评估与 MV 瓣叶和对合区面积相关的临床因素。MV 瓣叶和对合区面积之间存在显著的相关性（r = 0.499，P < 0.001）。MV 瓣叶面积与体表面积（BSA）密切相关（r = 0.905，P < 0.001），而不是与 LV 大小和年龄相关。MV 瓣叶面积/BSA 与男性性别（P = 0.002）、较低的舒张压（P = 0.042）和 LV 舒张末期容积（LVEDV）指数（P = 0.048）独立相关；MV 对合区面积/BSA 与较低的 LVEDV 指数（P = 0.01）独立相关。在 LV 收缩功能和大小正常的患者中，MV 瓣叶大小对 MV 对合的功能有显著影响。MV 瓣叶的大小可能由体型内在决定，而不是年龄和 LV 大小，并且 MV 瓣叶面积/BSA 相对恒定。另一方面，一些临床因素也可能影响 MV 瓣叶和对合区面积。
