Association of Relatively Short Posterior Mitral Leaflet With Mitral Regurgitation in Patients With Atrial Fibrillation
Background:The underlying mechanism of mitral regurgitation (MR) in atrial fibrillation (AF) is an isolated annulus dilation caused by left atrial (LA) remodeling. However, the association of mitral valve (MV) geometry with MR in AF patients remains unclear.Methods and Results:We studied 96 AF patie...
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| Veröffentlicht in: | Circulation Journal 2019/10/25, Vol.83(11), pp.2312-2319 |
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| creator | Takada, Hiroki Tanaka, Hidekazu Yokota, Shun Mukai, Jun Suto, Makiko Soga, Fumitaka Hatani, Yutaka Matsuzoe, Hiroki Hatazawa, Keiko Matsumoto, Kensuke Fukuzawa, Koji Hirata, Ken-ichi |
| description | Background:The underlying mechanism of mitral regurgitation (MR) in atrial fibrillation (AF) is an isolated annulus dilation caused by left atrial (LA) remodeling. However, the association of mitral valve (MV) geometry with MR in AF patients remains unclear.Methods and Results:We studied 96 AF patients with preserved left ventricular ejection fraction (LVEF). MV geometry was evaluated with 3-dimensional transesophageal echocardiography (3D-TEE). Mitral annulus area of the MR group (n=11, ≥ moderate) was significantly larger (10.6±1.8 vs. 8.2±1.5 cm2, P |
| doi_str_mv | 10.1253/circj.CJ-19-0529 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2292999454</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2292999454</sourcerecordid><originalsourceid>FETCH-LOGICAL-c579t-64cea549074266aa058d7f3886f753ad99c2ea7ffb04e9449df4d93143871a083</originalsourceid><addsrcrecordid>eNpFkE1vEzEQhi0EoqXlzgntkcsWf-56jlFEW6ogqkLF0XK848TRZl1sB9R_3002bS8zr6xnHlkvIZ8YvWBcia8uJLe5mN_UDGqqOLwhp0zItpaa07eH3NSgpTghH3LeUMqBKnhPTgRTvBVCn5L_s5yjC7aEOFTRV3fYj_kf9o_Vr3VMpbqNuWAKMVU_Qkm2rxZofY-l-hPK-vntDle7tApl0oShuh0TDiVP1KykMFKXYZlC3x-gc_LO2z7jx-M-I_eX337Pr-vFz6vv89midqqFUjfSoVUSaCt501hLle5aL7RufKuE7QAcR9t6v6QSQUrovOxAMCl0yyzV4ox8mbwPKf7dYS5mG7LD8RcDxl02nAMHAKnkiNIJdSnmnNCbhxS2Nj0aRs2-bnOo28xvDAOzr3s8-Xy075Zb7F4OnvsdgasJ2ORiV_gC2FSC6_Fo1MIwtp-v6ldibZPBQTwBUwmXew</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2292999454</pqid></control><display><type>article</type><title>Association of Relatively Short Posterior Mitral Leaflet With Mitral Regurgitation in Patients With Atrial Fibrillation</title><source>MEDLINE</source><source>J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Takada, Hiroki ; Tanaka, Hidekazu ; Yokota, Shun ; Mukai, Jun ; Suto, Makiko ; Soga, Fumitaka ; Hatani, Yutaka ; Matsuzoe, Hiroki ; Hatazawa, Keiko ; Matsumoto, Kensuke ; Fukuzawa, Koji ; Hirata, Ken-ichi</creator><creatorcontrib>Takada, Hiroki ; Tanaka, Hidekazu ; Yokota, Shun ; Mukai, Jun ; Suto, Makiko ; Soga, Fumitaka ; Hatani, Yutaka ; Matsuzoe, Hiroki ; Hatazawa, Keiko ; Matsumoto, Kensuke ; Fukuzawa, Koji ; Hirata, Ken-ichi</creatorcontrib><description>Background:The underlying mechanism of mitral regurgitation (MR) in atrial fibrillation (AF) is an isolated annulus dilation caused by left atrial (LA) remodeling. However, the association of mitral valve (MV) geometry with MR in AF patients remains unclear.Methods and Results:We studied 96 AF patients with preserved left ventricular ejection fraction (LVEF). MV geometry was evaluated with 3-dimensional transesophageal echocardiography (3D-TEE). Mitral annulus area of the MR group (n=11, ≥ moderate) was significantly larger (10.6±1.8 vs. 8.2±1.5 cm2, P<0.0001), and relative posterior mitral leaflet (PML) area (PML area / mitral annulus area) was significantly smaller (0.51±0.06 vs. 0.57±0.01, P=0.002) than in the non-MR group (n=85, <moderate). Multivariate logistic regression analysis showed that, in addition to LA volume index (LAVI), a relative PML area was independently associated with MR. For sequential logistic regression models to determine the association of MR, clinical variables including age, gender and LVEF were improved by the addition of LAVI (P<0.001) and was improved by addition of mitral annulus area (P=0.01), and further improved by addition of relative PML area (P<0.001).Conclusions:A relatively short PML plays an important role in the development of MR in AF patients. Assessment of MV geometry by 3D-TEE may thus have clinical implications for better surgical management of AF patients with significant MR.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-19-0529</identifier><identifier>PMID: 31527338</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Aged ; Aged, 80 and over ; Atrial fibrillation ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - physiopathology ; Atrial Function, Left ; Atrial Remodeling ; Echocardiography ; Echocardiography, Doppler, Color ; Echocardiography, Three-Dimensional ; Echocardiography, Transesophageal ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Mitral regurgitation ; Mitral valve ; Mitral Valve - diagnostic imaging ; Mitral Valve - physiopathology ; Mitral Valve Insufficiency - diagnostic imaging ; Mitral Valve Insufficiency - etiology ; Mitral Valve Insufficiency - physiopathology ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors</subject><ispartof>Circulation Journal, 2019/10/25, Vol.83(11), pp.2312-2319</ispartof><rights>2019 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c579t-64cea549074266aa058d7f3886f753ad99c2ea7ffb04e9449df4d93143871a083</citedby><cites>FETCH-LOGICAL-c579t-64cea549074266aa058d7f3886f753ad99c2ea7ffb04e9449df4d93143871a083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31527338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takada, Hiroki</creatorcontrib><creatorcontrib>Tanaka, Hidekazu</creatorcontrib><creatorcontrib>Yokota, Shun</creatorcontrib><creatorcontrib>Mukai, Jun</creatorcontrib><creatorcontrib>Suto, Makiko</creatorcontrib><creatorcontrib>Soga, Fumitaka</creatorcontrib><creatorcontrib>Hatani, Yutaka</creatorcontrib><creatorcontrib>Matsuzoe, Hiroki</creatorcontrib><creatorcontrib>Hatazawa, Keiko</creatorcontrib><creatorcontrib>Matsumoto, Kensuke</creatorcontrib><creatorcontrib>Fukuzawa, Koji</creatorcontrib><creatorcontrib>Hirata, Ken-ichi</creatorcontrib><title>Association of Relatively Short Posterior Mitral Leaflet With Mitral Regurgitation in Patients With Atrial Fibrillation</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:The underlying mechanism of mitral regurgitation (MR) in atrial fibrillation (AF) is an isolated annulus dilation caused by left atrial (LA) remodeling. However, the association of mitral valve (MV) geometry with MR in AF patients remains unclear.Methods and Results:We studied 96 AF patients with preserved left ventricular ejection fraction (LVEF). MV geometry was evaluated with 3-dimensional transesophageal echocardiography (3D-TEE). Mitral annulus area of the MR group (n=11, ≥ moderate) was significantly larger (10.6±1.8 vs. 8.2±1.5 cm2, P<0.0001), and relative posterior mitral leaflet (PML) area (PML area / mitral annulus area) was significantly smaller (0.51±0.06 vs. 0.57±0.01, P=0.002) than in the non-MR group (n=85, <moderate). Multivariate logistic regression analysis showed that, in addition to LA volume index (LAVI), a relative PML area was independently associated with MR. For sequential logistic regression models to determine the association of MR, clinical variables including age, gender and LVEF were improved by the addition of LAVI (P<0.001) and was improved by addition of mitral annulus area (P=0.01), and further improved by addition of relative PML area (P<0.001).Conclusions:A relatively short PML plays an important role in the development of MR in AF patients. Assessment of MV geometry by 3D-TEE may thus have clinical implications for better surgical management of AF patients with significant MR.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atrial fibrillation</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Function, Left</subject><subject>Atrial Remodeling</subject><subject>Echocardiography</subject><subject>Echocardiography, Doppler, Color</subject><subject>Echocardiography, Three-Dimensional</subject><subject>Echocardiography, Transesophageal</subject><subject>Female</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mitral regurgitation</subject><subject>Mitral valve</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - physiopathology</subject><subject>Mitral Valve Insufficiency - diagnostic imaging</subject><subject>Mitral Valve Insufficiency - etiology</subject><subject>Mitral Valve Insufficiency - physiopathology</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1vEzEQhi0EoqXlzgntkcsWf-56jlFEW6ogqkLF0XK848TRZl1sB9R_3002bS8zr6xnHlkvIZ8YvWBcia8uJLe5mN_UDGqqOLwhp0zItpaa07eH3NSgpTghH3LeUMqBKnhPTgRTvBVCn5L_s5yjC7aEOFTRV3fYj_kf9o_Vr3VMpbqNuWAKMVU_Qkm2rxZofY-l-hPK-vntDle7tApl0oShuh0TDiVP1KykMFKXYZlC3x-gc_LO2z7jx-M-I_eX337Pr-vFz6vv89midqqFUjfSoVUSaCt501hLle5aL7RufKuE7QAcR9t6v6QSQUrovOxAMCl0yyzV4ox8mbwPKf7dYS5mG7LD8RcDxl02nAMHAKnkiNIJdSnmnNCbhxS2Nj0aRs2-bnOo28xvDAOzr3s8-Xy075Zb7F4OnvsdgasJ2ORiV_gC2FSC6_Fo1MIwtp-v6ldibZPBQTwBUwmXew</recordid><startdate>20191025</startdate><enddate>20191025</enddate><creator>Takada, Hiroki</creator><creator>Tanaka, Hidekazu</creator><creator>Yokota, Shun</creator><creator>Mukai, Jun</creator><creator>Suto, Makiko</creator><creator>Soga, Fumitaka</creator><creator>Hatani, Yutaka</creator><creator>Matsuzoe, Hiroki</creator><creator>Hatazawa, Keiko</creator><creator>Matsumoto, Kensuke</creator><creator>Fukuzawa, Koji</creator><creator>Hirata, Ken-ichi</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20191025</creationdate><title>Association of Relatively Short Posterior Mitral Leaflet With Mitral Regurgitation in Patients With Atrial Fibrillation</title><author>Takada, Hiroki ; Tanaka, Hidekazu ; Yokota, Shun ; Mukai, Jun ; Suto, Makiko ; Soga, Fumitaka ; Hatani, Yutaka ; Matsuzoe, Hiroki ; Hatazawa, Keiko ; Matsumoto, Kensuke ; Fukuzawa, Koji ; Hirata, Ken-ichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c579t-64cea549074266aa058d7f3886f753ad99c2ea7ffb04e9449df4d93143871a083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atrial fibrillation</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Function, Left</topic><topic>Atrial Remodeling</topic><topic>Echocardiography</topic><topic>Echocardiography, Doppler, Color</topic><topic>Echocardiography, Three-Dimensional</topic><topic>Echocardiography, Transesophageal</topic><topic>Female</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mitral regurgitation</topic><topic>Mitral valve</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - physiopathology</topic><topic>Mitral Valve Insufficiency - diagnostic imaging</topic><topic>Mitral Valve Insufficiency - etiology</topic><topic>Mitral Valve Insufficiency - physiopathology</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takada, Hiroki</creatorcontrib><creatorcontrib>Tanaka, Hidekazu</creatorcontrib><creatorcontrib>Yokota, Shun</creatorcontrib><creatorcontrib>Mukai, Jun</creatorcontrib><creatorcontrib>Suto, Makiko</creatorcontrib><creatorcontrib>Soga, Fumitaka</creatorcontrib><creatorcontrib>Hatani, Yutaka</creatorcontrib><creatorcontrib>Matsuzoe, Hiroki</creatorcontrib><creatorcontrib>Hatazawa, Keiko</creatorcontrib><creatorcontrib>Matsumoto, Kensuke</creatorcontrib><creatorcontrib>Fukuzawa, Koji</creatorcontrib><creatorcontrib>Hirata, Ken-ichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takada, Hiroki</au><au>Tanaka, Hidekazu</au><au>Yokota, Shun</au><au>Mukai, Jun</au><au>Suto, Makiko</au><au>Soga, Fumitaka</au><au>Hatani, Yutaka</au><au>Matsuzoe, Hiroki</au><au>Hatazawa, Keiko</au><au>Matsumoto, Kensuke</au><au>Fukuzawa, Koji</au><au>Hirata, Ken-ichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Relatively Short Posterior Mitral Leaflet With Mitral Regurgitation in Patients With Atrial Fibrillation</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2019-10-25</date><risdate>2019</risdate><volume>83</volume><issue>11</issue><spage>2312</spage><epage>2319</epage><pages>2312-2319</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:The underlying mechanism of mitral regurgitation (MR) in atrial fibrillation (AF) is an isolated annulus dilation caused by left atrial (LA) remodeling. However, the association of mitral valve (MV) geometry with MR in AF patients remains unclear.Methods and Results:We studied 96 AF patients with preserved left ventricular ejection fraction (LVEF). MV geometry was evaluated with 3-dimensional transesophageal echocardiography (3D-TEE). Mitral annulus area of the MR group (n=11, ≥ moderate) was significantly larger (10.6±1.8 vs. 8.2±1.5 cm2, P<0.0001), and relative posterior mitral leaflet (PML) area (PML area / mitral annulus area) was significantly smaller (0.51±0.06 vs. 0.57±0.01, P=0.002) than in the non-MR group (n=85, <moderate). Multivariate logistic regression analysis showed that, in addition to LA volume index (LAVI), a relative PML area was independently associated with MR. For sequential logistic regression models to determine the association of MR, clinical variables including age, gender and LVEF were improved by the addition of LAVI (P<0.001) and was improved by addition of mitral annulus area (P=0.01), and further improved by addition of relative PML area (P<0.001).Conclusions:A relatively short PML plays an important role in the development of MR in AF patients. Assessment of MV geometry by 3D-TEE may thus have clinical implications for better surgical management of AF patients with significant MR.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>31527338</pmid><doi>10.1253/circj.CJ-19-0529</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Atrial fibrillation Atrial Fibrillation - complications Atrial Fibrillation - diagnosis Atrial Fibrillation - physiopathology Atrial Function, Left Atrial Remodeling Echocardiography Echocardiography, Doppler, Color Echocardiography, Three-Dimensional Echocardiography, Transesophageal Female Hemodynamics Humans Male Middle Aged Mitral regurgitation Mitral valve Mitral Valve - diagnostic imaging Mitral Valve - physiopathology Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - etiology Mitral Valve Insufficiency - physiopathology Predictive Value of Tests Retrospective Studies Risk Factors |
| title | Association of Relatively Short Posterior Mitral Leaflet With Mitral Regurgitation in Patients With Atrial Fibrillation |
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