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Mitral anular calsification (MAC) is a chronic and degenerative process which occurs in fibroz circle, supporting mitral valv. It is found that mitral annüler calcification is associated with hearth failure, coronary artery disease and endocarditis in many micro scaled studies. Moreover, it is declared as cardiovascular mortality identifier. Functions and volume of left atrial (LA) can be evaluated with many methods. However, these methods have restrictive specialities. 3-Dimension-echocardiyography (3D-ECHO) is a new method for showing the change of LA volume. In evaluating of LA volume, results can be acquired with magnetic resonance imaging. In our studies, we evaluated LA mechanical fuctions with 3D-ECHO proved its priority to 2D-ECHO to the patients detected mitral annüler calcification.
In ECHO for the study, totally 60 people were included occuring 30 patients(16 men, 14 women) who normal left ventricul (LV) sistolic functions and detected MAC and 30 healthy people (19 men, 11 women)who were voluntary control group. Anamnesis of all people, who participated in the study, were taken and their physical examinations were done.as indicators sistolic and diastolic functions records of LV EF, Pulse Wave Doppler and tissue doppler with E wave, A wave, E/A rate were taken. LA maximum volume (Vmax), LA minimum volume (Vmin), total stroke volume(TSV), active stroke volume (ASV), expansion index (EI), total ejection fraction (TEF), active ejection fraction (AEF) and LA volume index (LAVİ) merits, which are LA function indicators, were measured.
Among two groups, significant statistical differencecould not be found about their age, gender, body mass index (BMI) and other demographic characteristics. E wave, E/A rate, Em, Em/Am rate are detected lower with the patients with mitral annüler calcification. LA Vmaks, Vmin, VpreA: were higher in the group of MAC (p 0.001). TSV, ASV, EI, TEF, AEF, LAVİ are found meaningful as statistical. Positive correlation was followed between age with LAVİ and Vmax (r=0.404, r=0.365 in turn).
Aimed to investigate the functions of LA in patients with MAC by using the method of 3D-ECHO in this study, we found that LA function parameters are different from the control group. The reason for this may be related with patients with LV diastolic dysfunction. We demonstrated by 3D-ECHO in patients with MAC, LA mechanical dysfunction which are known to cause an increase in mortality and morbidityin several groups of illness.
As a result, dysfunction LA can cause an increase in mortality and morbidity even in patients with mitral annüler calcification.
|MAC n=30||Control n=30||p|
Vmaks: LA maximum volume, Vmin: LA minimum volume, VpreA: pre contraction atrial volume, TSV: LA total stroke volume, TEF: LA total ejection fraction, ASV: LA active stroke volume, AEF: LA active ejection fraction, PEF: LA passive ejection fraction, EI: LA expansion index