来自MAGYAR-健康研究的关于健康成年人二尖瓣环尺寸、衍生的括约肌样特征与二尖瓣环平面收缩期纵向偏移之间关系的见解。
Insights into the relationship between mitral annular dimensions, derived sphincter-like features and systolic longitudinal excursion of the mitral annular plane in healthy adults from the MAGYAR-Healthy Study.
作者信息
Nemes Attila, Ambrus Nóra, Lengyel Csaba
机构信息
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
出版信息
Quant Imaging Med Surg. 2025 May 1;15(5):4748-4757. doi: 10.21037/qims-2024-2731. Epub 2025 Apr 28.
BACKGROUND
The mitral annulus (MA) is a fibrous ring with a three-dimensional (3D) movement during the cardiac cycle having an up-and-town longitudinal motion and a sphincter-like narrowing-dilating pattern respecting the cardiac cycle. In the clinical practice, the MA plane systolic excursion (MAPSE), a feature of MA longitudinal function, can be assessed by the simple and widely used M-mode echocardiography (MME), while changes of MA dimensions and derived functional properties can be accurately measured by 3D speckle-tracking echocardiography (3DSTE) at the same time. The aim of the present retrospective cohort study was to evaluate the associations between MME-derived MAPSE and 3DSTE-derived MA dimensions in healthy adults for better understanding their physiologic relationship.
METHODS
The subject group of 137 consecutive healthy individuals (34.8±12.3 years, 66 males) was classified into subgroups regarding their mean ± standard deviation (SD) of MAPSE and end-diastolic and end-systolic MA diameters (MAA-D and MAA-S, respectively). Cut-offs for MAPSE (11 and 17 mm), MAA-D (5.31 and 9.59 cm) and MAA-S (2.36 and 4.62 cm) were used to create the subgroups of subjects with less than mean - SD, mean and larger than mean + SD.
RESULTS
None of the MA dimensions (MAA-D: 7.07±2.20 . 7.40±2.03 . 8.00±2.34 cm, P=non-significant (ns) for all; MAA-S: 3.43±1.04 . 3.42±1.11 . 3.77±1.21 cm, P=ns for all) and derived functional properties differed significantly between the subgroups based on MAPSE. With increasing MAA-D, MAPSE did not change (13.8±2.9 . 14.0±2.9 . 14.6±3.1 mm, P=ns for all), while other MA dimensions and MA fractional area change showed a parallel increase. With increasing MAA-S, MA dimensions increased, while derived MA functional properties showed a parallel decrease with preserved MAPSE (14.4±2.5 . 13.9±2.8 . 14.5±3.7 mm, P=ns for all).
CONCLUSIONS
MME-derived MAPSE and 3DSTE-derived MA dimensions and derived functional 'sphincter-like' properties are not associated in healthy adults.
背景
二尖瓣环（MA）是一个纤维环，在心动周期中具有三维（3D）运动，呈现上下纵向运动以及类似括约肌的收缩-舒张模式，与心动周期相关。在临床实践中，二尖瓣环平面收缩期位移（MAPSE）作为二尖瓣环纵向功能的一个特征，可通过简单且广泛应用的M型超声心动图（MME）进行评估，而二尖瓣环尺寸的变化及其衍生的功能特性可同时通过三维斑点追踪超声心动图（3DSTE）进行精确测量。本回顾性队列研究的目的是评估健康成年人中MME得出的MAPSE与3DSTE得出的二尖瓣环尺寸之间的关联，以更好地理解它们的生理关系。
方法
连续纳入137名健康个体（年龄34.8±12.3岁，男性66名）作为研究对象，根据MAPSE以及舒张末期和收缩末期二尖瓣环直径（分别为MAA-D和MAA-S）的均值±标准差（SD）将其分为亚组。采用MAPSE（11和17mm）、MAA-D（5.31和9.59cm）和MAA-S（2.36和4.62cm）的截断值来创建低于均值-SD、均值以及高于均值+SD的受试者亚组。
结果
基于MAPSE划分的亚组之间，二尖瓣环的所有尺寸（MAA-D：7.07±2.20、7.40±2.03、8.00±2.34cm，P均为无显著性差异（ns）；MAA-S：3.43±1.04、3.42±1.11、3.77±1.21cm，P均为ns）及其衍生的功能特性均无显著差异。随着MAA-D增加，MAPSE没有变化（13.8±2.9、14.0±2.9、14.6±3.1mm，P均为ns），而二尖瓣环的其他尺寸和二尖瓣环面积变化分数则呈现平行增加。随着MAA-S增加，二尖瓣环尺寸增大，而衍生的二尖瓣环功能特性呈现平行下降，MAPSE保持不变（14.4±2.5、13.9±2.8、14.5±3.7mm，P均为ns）。
结论
在健康成年人中，MME得出的MAPSE与3DSTE得出的二尖瓣环尺寸及其衍生的“类似括约肌”功能特性之间无关联。
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