Left atrial remodeling in segmental vs. Global mitral valve prolapse: Three-dimensional echocardiography

Atsushi Hayashi, Shota Fukuda, Keitaro Mahara, Soshi Hei, Takeshi Onoue, Yuichiro Kado, Yasufumi Nagata, Mai Iwataki, Kyoko Otani, Tetsu Miyamoto, Yasushi Oginosawa, Shinjo Sonoda, Masataka Eto, Yosuke Nishimura, Shuichiro Takanashi, Robert A. Levine, Yutaka Otsuji

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Segmental and global mitral valve prolapse (MVP) comprise 2 representative phenotypes in this syndrome. While mitral regurgitation (MR) severity is a major factor causing left atrial (LA) remodeling in MVP, prominent mitral valve (MV) annulus dilatation in global MVP may specifically cause inferiorly predominant LA remodeling. We compared MV annulus and LA geometry in patients with segmental and global MVP. Methods and Results: LA volume as well as inferior, middle, and superior LA cross-sectional areas (CSA) were measured on 3-D echocardiography in 20 controls, in 40 patients with segmental MVP, and in 18 with global MVP. On multivariate analysis, MR severity was primarily associated with LA dilatation in segmental MVP (P<0.001), while MV annular dilatation was primarily associated with LA dilatation in global MVP (P<0.001). Although there was no regional predominance in LA dilatation in segmental MVP, inferior predominance of LA dilatation was significant in global MVP (increase in inferior, middle, and superior LA-CSA relative to mean of the controls: +220±70% vs. +171±55% vs. +137±37%, P<0.001). Conclusions: LA remodeling in segmental and global MVP is considerably different regarding its association with MR volume or MV annular dilatation and its regional predominance. While MR volume may mainly contribute to LA remodeling in segmental MVP, MV annular dilatation seems to have an important role in LA remodeling in global MVP.

Original languageEnglish
Pages (from-to)2533-2540
Number of pages8
JournalCirculation Journal
Issue number12
Publication statusPublished - 2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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