Yıl: 2020 Cilt: 48 Sayı: 8 Sayfa Aralığı: 739 - 745 Metin Dili: İngilizce DOI: 10.5543/tkda.2020.52988 İndeks Tarihi: 26-06-2021

Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry

Öz:
Objective: Mitral valve prolapse (MVP) is a heart valve anomaly that affects a considerable segment of the population.Studies of patients with isolated MVP have shown that aortic distensibility decreased as the aortic diameter increased.The aim of this study was to compare evaluations of aorticdistensibility in MVP patients using both applanation tonometry and the conventional echocardiographic examination.Methods: A total of 36 consecutive patients with MVP (16male and 20 female) and 23 healthy controls (11 male and12 female) were included in this study. The difference in aortic diameter and distensibility was examined using echocardiography and pulse wave velocity (PWV) was measuredwith applanation tonometry.Results: According to the echocardiographic measurements,the aortic distensibility was lower in the MVP patients than inthe control group (6.2±4.0 cm².dyn⁻¹.10⁻⁶ vs. 10.0±5.2 cm².dyn⁻¹.10⁻⁶; p=0.02). The PWV measured with applanation tonometry was significantly higher in the MVP patients thanin the control group (9.0±2.4 m/s vs. 7.2±1.4 m/s; p=0.006).Conclusion: The results of this study showed that aortic distensibility was reduced in patients with isolated MVP compared with a healthy control group. There was a moderatenegative correlation between the results of both methods.
Anahtar Kelime:

Mitral kapak prolapsusunda aortik distensibilitenin ekokardiyografi ve aplanasyon tonometrisi ile değerlendirilmesi

Öz:
Amaç: Mitral kapak prolapsusu (MVP) popülasyonun büyük bir bölümünü etkileyen kalp kapak anomalisidir. Önceki çalışmalar, izole MVP hastalarında aort çapı arttıkça aort distensibilitesinin azaldığını göstermiştir. Bu çalışmanın amacı, konvansiyonel ekokardiyografik incelemeye ek olarak aort distensibilitesinin aplanasyon tonometrisi ile değerlendirilmesi ve MVP hastalarında her iki yöntemin karşılaştırılmasıdır. Yöntemler: Bu çalışmaya 36 mitral kapak prolapsusu (16 erkek ve 20 kadın) ve 23 sağlıklı kontrol gruubu (11 erkek ve 12 kadın) dahil edildi. Tüm hastalarda ve kontrol grubunda; ekokardiyografi ile aort çapındaki değişiklik ve distensibilite incelendi ve aplanasyon tonometrisi ile nabız dalga hızı (NDH) ölçüldü. Bulgular: Ekokardiyografik ölçümlere göre; aort distensibilitesi MVP hasta grubunda kontrol grubuna göre daha düşüktü (6.2±4.0 ve 10.0±5.2 cm².dyn⁻¹.10⁻⁶, p=0.02). Aplanasyon tonometrisi ile ölçülen NDH, MVP hastalarında kontrol grubuna göre anlamlı olarak daha yüksekti (9.0±2.4 ve 7.2±1.4 m/s p=0.006). Sonuç: Bu çalışma, izole MVP’li hastalarda aort distensibilitesinin sağlıklı kontrol grubuna göre azaldığını göstermiştir. Her iki yöntemin sonuçları arasında orta derecede negatif korelasyon vardı.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Theal M, Sleik K, Anand S, Yi Q, Yusuf S, Lonn E. Prevalence of mitral valve prolapse in ethnic groups. Can J Cardiol 2004;20:511−5.
  • 2. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010;55:1318−27.
  • 3. Chae CU, Pfeffer MA, Glynn RJ, Mitchell GF, Taylor JO, Hennekens CH. Increased pulse pressure and risk of heart failure in the elderly. JAMA 1999;281:634–9.
  • 4. Franklin SS, Larson MG, Khan SA, Wong ND, Leip FP, Kannel WB, et al. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation 2001;103:1245–9.
  • 5. Mitchell GF, Pfeffer MA, Braunwald E, Rouleau JL, Bernstein V, Geltman EM, et al. Sphygmomanometrically determined pulse pressure is a powerful independent predictor of recurrent events after myocardial infarction in patients with impaired left ventricular function. Circulation 1997;96:4254– 60. 97.
  • 6. Vaccarino V, Berger A, Abramson J, Black H, Setaro J, Davey J, et al. Pulse pressure and risk of cardiovascular events in the systolic hypertension in the elderly program. Am J Cardiol 2001;88:980–6.
  • 7. Kostis J, Lawrence-Nelson J, Ranjan R, Wilson A, Kostis W, Lacy C. Association of increased pulse pressure with the development of heart failure in SHEP. Systolic Hypertension in the Elderly (SHEP) Cooperative Research Group. Am J Hypertens 2001;14:798–803.
  • 8. Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness on survival in endstage renal disease. Circulation 1999;99:2434–9.
  • 9. Forette F, Seux ML, Staessen JA, Thijs L, Birkenhager WH, Babarskiene MR, et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet 1998;352:1347–51.
  • 10. Benetos A, Safar M, Rudnichi A, Smulyan H, Richard JL, Ducimetieère P, et al. Pulse pressure: a predictor of long-term cardiovascular mortality in a French male population. Hypertension 1997;30:1410−5.
  • 11. Lehmann ED, Parker JR, Hopkins KD, Taylor MG, Gosling RG. Validation and reproducibility of pressure-corrected aortic distensibility measurements using pulse-wave-velocity Doppler ultrasound. J Biomed Eng 1993;15:221−8.
  • 12. Asmar RG, Topouchian JA, Benetos A, Sayegh FA, Mourad JJ, Safar ME. Non-invasive evaluation of arterial abnormalities in hypertensive patients. J Hypertens Suppl 1997;15:S99−107.
  • 13. Asmar R, Benetos A, Topouchian J, Laurent P, Pannier B, Brisac AM, et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. Hypertension 1995;26:485−90.
  • 14. Nollen GJ, Groenink M, Tijssen JG, Van Der Wall EE, Mulder BJ. Aortic stiffness and diameter predict progressive aortic dilatation in patients with Marfan syndrome. Eur Heart J 2004;25:1146−52.
  • 15. Matos-Souza JR, Fernandes-Santos ME, Hoehne EL, Franchini KG, Nadruz W Jr. Isolated mitral valve prolapse is an independent predictor of aortic root size in a general population. Eur J Echocardiogr 2010;11:302−5
  • 16. Kardesoglu E, Ozmen N, Aparci M, Cebeci BS, Uz O, Dincturk M. Abnormal elasticproperties of the aorta in the mitral valve prolapse syndrome. Acta Cardiol 2007;62:151−5.
  • 17. Zipes DP, Libby P, O Bonow R, Braunwald E. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia: Elsevier Saunders; 2008. p. 1577−82.
  • 18. O’Rourke RA. Syndrome of mitral valve prolapse. In: Alpert JS, Dalen JE, Rahimtoola SH, editors. Valvular Heart Disease. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 157−82.
  • 19. Becker AE, Davies MJ. Pathomorphology of mitral valve prolapse. In: Boudoulas H, Wooley CF, editors. Mitral Valve: Floppy Mitral Valve, Mitral Valve Prolapse, Mitral Valvular Regurgitation. 2nd ed. Armonk, NY: Futura; 2000. p. 91−114.
  • 20. Rabkin E, Aikawa M, Stone JR, Fukumoto Y, Libby P, Schoen FJ. Activated interstitial myofibroblasts express catabolic enzymes and mediate matrix remodeling in myxomatous heart valves. Circulation 2001;104:2525−32. 17. 15.
  • 21. Lakatta EG. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part III: cellular and molecular clues to heart and arterial aging. Circulation 2003;107:490–7.
  • 22. Vitarelli A, Conde Y, Cimino E, D’Angeli I, D’Orazio S, Stellato S, et al. Aortic wall mechanics in the Marfan syndrome assessed by transesophageal tissue Doppler echocardiography. Am J Cardiol 2006;97:571−7.
  • 23. Recchia D, Sharkey AM, Bosner MS, Kouchoukos NT, Wickline SA. Sensitive detection of abnormal aortic architecture in Marfan syndrome with high-frequency ultrasonic tissue characterization. Circulation 1995;91:1036−43.
  • 24. Theofilogiannakos EK, Boudoulas KD, Gawronski BE, Langaee TY, Dardas PS, Ninios V, et al. Floppy mitral valve/mi tral valve prolapse syndrome: Beta-adrenergic receptor polymorphism may contribute to the pathogenesis of symptoms. J Cardiol 2015;65:434−8. 28.
  • 25. Boudoulas H, Reynolds JC, Mazzaferri E, Wooley CF. Mitral valve prolapse syndrome: the effect of adrenergic stimulation. J Am Coll Cardiol 1983;2:638–44
  • 26. Mowafy H, Lilly S, Orsinelli DA, Rushing G, Crestanello J, Boudoulas KD. Aortic Dysfunction in Mitral Regurgitation Due to Floppy Mitral Valve/MitralValve Prolapse. Aorta (Stamford) 2018;6:75−80.
  • 27. Unlu M, Demirkol S, Aparci M, Arslan Z, Balta S, Dogan U, et al. Why aortic elasticity differs among classical andnon-classical mitral valve prolapsed? Clin Exp Hypertens 2014;36:148−52.
  • 28. Erolu E, Akalın F, Çetiner N, Şaylan Çevik B. Aortic elasticity and carotidintima-media thickness in children with mitral valve prolapse. Cardiol Young 2018;28:292−301.
APA Kalkan S, efe s, Tasar O, Karabay C, KIRMA C (2020). Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. , 739 - 745. 10.5543/tkda.2020.52988
Chicago Kalkan Sedat,efe suleyman,Tasar Onur,Karabay Can Yucel,KIRMA Cevat Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. (2020): 739 - 745. 10.5543/tkda.2020.52988
MLA Kalkan Sedat,efe suleyman,Tasar Onur,Karabay Can Yucel,KIRMA Cevat Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. , 2020, ss.739 - 745. 10.5543/tkda.2020.52988
AMA Kalkan S,efe s,Tasar O,Karabay C,KIRMA C Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. . 2020; 739 - 745. 10.5543/tkda.2020.52988
Vancouver Kalkan S,efe s,Tasar O,Karabay C,KIRMA C Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. . 2020; 739 - 745. 10.5543/tkda.2020.52988
IEEE Kalkan S,efe s,Tasar O,Karabay C,KIRMA C "Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry." , ss.739 - 745, 2020. 10.5543/tkda.2020.52988
ISNAD Kalkan, Sedat vd. "Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry". (2020), 739-745. https://doi.org/10.5543/tkda.2020.52988
APA Kalkan S, efe s, Tasar O, Karabay C, KIRMA C (2020). Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. Türk Kardiyoloji Derneği Arşivi, 48(8), 739 - 745. 10.5543/tkda.2020.52988
Chicago Kalkan Sedat,efe suleyman,Tasar Onur,Karabay Can Yucel,KIRMA Cevat Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. Türk Kardiyoloji Derneği Arşivi 48, no.8 (2020): 739 - 745. 10.5543/tkda.2020.52988
MLA Kalkan Sedat,efe suleyman,Tasar Onur,Karabay Can Yucel,KIRMA Cevat Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. Türk Kardiyoloji Derneği Arşivi, vol.48, no.8, 2020, ss.739 - 745. 10.5543/tkda.2020.52988
AMA Kalkan S,efe s,Tasar O,Karabay C,KIRMA C Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. Türk Kardiyoloji Derneği Arşivi. 2020; 48(8): 739 - 745. 10.5543/tkda.2020.52988
Vancouver Kalkan S,efe s,Tasar O,Karabay C,KIRMA C Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry. Türk Kardiyoloji Derneği Arşivi. 2020; 48(8): 739 - 745. 10.5543/tkda.2020.52988
IEEE Kalkan S,efe s,Tasar O,Karabay C,KIRMA C "Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry." Türk Kardiyoloji Derneği Arşivi, 48, ss.739 - 745, 2020. 10.5543/tkda.2020.52988
ISNAD Kalkan, Sedat vd. "Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry". Türk Kardiyoloji Derneği Arşivi 48/8 (2020), 739-745. https://doi.org/10.5543/tkda.2020.52988