Calcific Extension Towards the Mitral Valve causes with Non-Rheumatic Mitral Stenosis in Degenerative Aortic Stenosis: Real-Time 3D Transesophageal Echocardiography Study

• Project/Area Number: 23500574
• 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: TAKEUCHI Masaaki 産業医科大学, 医学部, 准教授 (30236434)
• Co-Investigator(Kenkyū-buntansha): OTSUJI Yutaka 産業医科大学, 医学部, 教授 (30264427) ; HARUKI Nobuhiko 産業医科大学, 医学部, 助教 (70469394) ; NISHIMURA Yosuke 産業医科大学, 大学病院, 准教授 (50301338)
• Project Period (FY): 2011 – 2013
• Project Status: Completed (Fiscal Year 2013)
• Budget Amount: ¥5,460,000 (Direct Cost: ¥4,200,000、Indirect Cost: ¥1,260,000); Fiscal Year 2013: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2012: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2011: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
• Keywords: 大動脈弁狭窄症 / 僧帽弁狭窄症 / 3次元心エコー

Research Abstract

The impact of mitral annular calcification on mitral valve (MV) function and the change of flow rate on MV dynamics has not been established in aortic stenosis (AS). 3D transesophageal images of MV were acquired in AS patients and control subjects. Outer and inner border of the mitral annular area (MAA) and mital valve area (MVA) were measured. Stress echocardiography had performed in 10 patients after aortic valve replacement. Inner MAA was significantly smaller in patients with AS compared to control. Maximal anterior and posterior leaflet opening angle and MVA was also significantly smaller. Multivariable analysis revealed that effective MAA and posterior leaflet opening angle were independent predictors for MVA. MVA became larger during stress echocardiography. Its increment was directly correlated to the change in diastolic flow rate.
Conclusion: Although calcific extension to MV in AS patients is associated with significant non-rheumatic mitral stenosis, MVA is flow-dependent.

Research Products

• [Presentation] Impact of surgical aortic valve replacement on mitral valve geometry in patients with aortic stenosis (2014)
  • Author(s): Mai Iwataki, Masaaki Takeuchi, Yasushi Nagata, Attsushi Hayashi, Kyoko Otani, Shota Fukuda, Hidetoshi Yoshitani, Yutaka Otsuji
  • Organizer: 第78回日本循環器学会学術集会
  • Place of Presentation: 東京
• [Presentation] Calcific extension towards the mitral valve in degenerative aortic stenosis causes non-rheumatic mitral stenosis : Real-time 3D transesophageal echocardiography study (2012)
  • Author(s): Kyoko Otani, Masaaki Takeuchi, Kyoko Kaku, Nobuhiko Haruki, Hidetoshi Yoshitani, Yutaka Otsuji
  • Organizer: 第76回日本循環器学会学術集会
  • Place of Presentation: 福岡
• [Presentation] Calcific extension towards the mitral valve in degenerative aortic stenosis causes non-rheumatic mitral stenosis: Real-time 3DTEE study (2012)
  • Author(s): 大谷恭子、竹内正明、加来京子、春木伸彦、芳谷英俊、尾辻豊
  • Organizer: 第76回日本循環器病学会学術集会
  • Place of Presentation: 福岡国際会議場(福岡市)