Subvalvular Papillary Muscles Displacement/Dysfunction in Patients with Late Systolic Mitral Valve Prolapse

2014 Fiscal Year Final Research Report

• Project/Area Number: 24500562
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical systems
• Research Institution: University of Occupational and Environmental Health, Japan
• Principal Investigator: OTSUJI Yutaka 産業医科大学, 医学部, 教授 (30264427)
• Co-Investigator(Kenkyū-buntansha): TAKEUCHI Masaaki 産業医科大学, 医学部, 准教授 (30236434) ; YOSHITANI Hidetoshi 産業医科大学, 医学部, 助教 (30351894) ; HARUKI Nobuhiko 産業医科大学, 医学部, 助教 (70469394) ; KUWAKI Hiroshi 産業医科大学, 医学部, 修練指導医 (80623868) ; FUKUDA Shota 産業医科大学, 医学部, 助教 (00464610)
• Project Period (FY): 2012-04-01 – 2015-03-31
• Keywords: mitral valve / papillary muscle / echocardiography

Outline of Final Research Achievements

Background： We hypothesized that impaired subvalvular geometric stability with papillary muscles (PMs) displacement and/or dysfunction is associated with late-systolic mitral valve prolapse (MVP).
Methods and results：In 15 controls, 10 patients with holo-systolic MVP, and 14 with late-systolic MVP, 1) distances between papillary muscles (PMs) base, PMs tip, and MV annulus and 2) MV coaptation height from its annulus were measured by echocardiography speckle tracking analysis. By multivariate analysis, systolic shift of MV coaptation toward LA was significantly correlated with systolic shift of PMs tip toward LA (r=0.80, p<0.0001), and systolic shift of PMs tip was significantly correlated with both systolic shift of PMs base toward LA (r=0.69, p<0.0001) and reduced PMs contraction(r=0.52, p=0.0007).
Conclusion：Late systolic MVP was associated with impaired stability in subvalvular geometry, including systolic shift of PMs toward LA and impaired PMs contraction.

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