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Cyclic Variation of Thickness in An Age-Related Thick Mitral Valve Observed by Transthoracic Echocardiography

Shoichi Senda, MD

Kimiteru Manabe, MD

Haruhiko Sakamoto, MD

Aki Kinoshita, MD

Seiji Sakamoto, MD

Hirohide Matsuo, MD

Katsufumi Mizushige, MD

Second Department of Internal Medicine Kagawa Medical University 1750-1, Miki-cho, Kita-gun Kagawa, 761-0793, Japan

The cyclic variation of thickness during the cardiac cycle in age-related degenerative mitral valve (MV) has not been reported. Transthoracic echocardiography was used to evaluate the cyclic alteration in MV thickness in 40 patients with age-related MV thick ening (diastolic MV thickness 4 mm, age 70 ± 14 years), 10 with mitral valve prolapse (MVP, age 49 ±11 years), 10 with rheumatic mitral stenosis (MS, age 66 ±9 years), and 31 control subjects (diastolic MV thickness 3.6 mm, 53 ±17 years). After determination of the site of maximal thickness during diastole, the maximal and minimal thickness during systole of the anterior MV were measured. The percent change in MV thickness from diastole to systole (%T) was calculated. The mitral regurgitation (MR) area was measured on color Doppler echocardiogram. The %T (mean ± sd) in age-related thickened MV and MVP groups were similar and significantly greater than that in control (60 ±8%, 61 ±6% vs 32 ±9%, p < 0.001). MR area was significantly greater in the age- related thickened MV group than that in controls (160 ±205 mm² vs 14 ±40 mm², p < 0.05). The %T in MS (10 ±6%) was smallest (p < 0.001). A large cyclic alteration in valvular thickness was observed in the age-related degeneration of the MV and may be the cause of large MR despite no leaflet prolapse. The echocardiographic assessment of cyclic variation of MV thickness is feasible for estimating the histologic damage in thick MV.

Angiology, Vol. 50, No. 9, 735-743 (1999)
DOI: 10.1177/000331979905000907


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