Three-Dimensional Mitral Valve Morphology in Children and Young Adults With Marfan Syndrome.
Three-Dimensional Mitral Valve Morphology in Children and Young Adults With Marfan Syndrome.
复制标题
Marfan综合征儿童和年轻人的三维二尖瓣瓣膜形态。
DOI：
10.1016/j.echo.2018.06.009
复制
发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Harrild DM
中科院分区：
文献类型：
--
作者：
Jolley MA;Hammer PE;Ghelani SJ;Adar A;Sleeper LA;Lacro RV;Marx GR;Nathan M;Harrild DM
二尖瓣脱垂 (MVP) 在马凡综合征 (MFS) 儿童中很常见，并与不同程度的二尖瓣反流相关。然而，MFS 儿童二尖瓣 (MV) 的 3 维 (3D) 形态及其与二尖瓣反流 (MR) 程度的关系尚不清楚。本研究的目的是描述 MFS 儿童 MV 的 3D 形态，并将其与正常儿童进行比较。对符合修订版 MFS 根特标准的 27 名患者（年龄 3-21 岁）以及 27 名年龄匹配（±1 岁）的正常儿童进行了 3D 经胸超声心动图检查。测量了 MV 装置在收缩中期的 3D 几何形状，并检查了其与临床和 2D 超声心动图参数的关联。与年龄匹配的对照组相比，MFS 儿童的 3D 环形面积更大（p<0.02）；较小的环形高度与连合宽度之比（p<0.001）；更大的浪涌量（P<0.001）；以及较小的帐篷高度、面积和体积（所有 P<0.001）。在多变量模型中，MFS 中较大的小叶波浪体积与 MR 中度或更大密切相关（p < 0.01）。 3D 指标的用户内和用户间差异是可以接受的。与正常对照相比，患有 MFS 的儿童的 MV 环更平坦且更扩张，波浪体积更大，隆起高度更小。较大的浪涌量与 MR 相关。 3D MV 量化可能有助于识别 MFS 和其他结缔组织疾病患者。在这一弱势群体中，有必要进一步研究 3D MV 几何形状及其与 MV 疾病临床进展的关系。
Mitral valve prolapse (MVP) is common in children with Marfan syndrome (MFS) and is associated with varying degrees of mitral regurgitation. However, the 3-dimensional (3D) morphology of the mitral valve (MV) in children with MFS and its relation to degree of mitral regurgitation (MR) are not known. The goals of this study were to describe the 3D morphology of the MV in children with MFS and to compare it to that of normal children. 3D transthoracic echocardiography was performed in 27 patients (age 3–21 years) meeting revised Ghent criteria for MFS as well as 27 normal children matched by age (±1 year). The 3D geometry of the MV apparatus in mid-systole was measured, and its association with clinical and 2D echocardiographic parameters was examined. Compared to age-matched controls, children with MFS had larger 3D annular area (p<0.02); smaller annular height-to-commissural-width ratio (p<0.001); greater billow volume (P<0.001); and smaller tenting height, area, and volume (P< 0.001 for all). In multivariate modeling larger leaflet billow volume in MFS was strongly associated with MR moderate or greater (p< 0.01). Intra- and inter-user variability of 3D metrics was acceptable. Children with MFS have flatter and more dilated MV annuli, greater billow volumes, and smaller tenting heights compared to normal controls. Larger billow volume is associated with MR. 3D MV quantification may contribute to identification of patients with MFS and other connective tissue disorders. Further study of 3D MV geometry and its relation to the clinical progression of MV disease is warranted in this vulnerable population.
登录
查看更多内容
影响因子：
37.8
作者：
LEVINE, RA;HANDSCHUMACHER, MD;WEYMAN, AE
通讯作者：
WEYMAN, AE
DOI：
10.1016/j.echo.2014.04.017
发表时间：
2014-08-01
影响因子：
6.5
作者：
Mihaila, Sorina;Muraru, Denisa;Badano, Luigi P.
通讯作者：
Badano, Luigi P.
DOI：
10.1109/tvcg.2007.70599
发表时间：
2007-11-01
影响因子：
5.2
作者：
Caban, Jesus J.;Joshi, Alark;Rheingans, Penny
通讯作者：
Rheingans, Penny
DOI：
10.1053/j.jvca.2012.06.017
发表时间：
2012-10-01
影响因子：
2.8
作者：
Mahmood, Feroze;Hess, Philip E.;Maslow, Andrew
通讯作者：
Maslow, Andrew
二尖瓣环动力学的三维超声心动图分析：瓣环成形术选择的意义。
影响因子：
37.8
作者：
Levack MM;Jassar AS;Shang EK;Vergnat M;Woo YJ;Acker MA;Jackson BM;Gorman JH 3rd;Gorman RC
通讯作者：
Gorman RC