The association of severe mitral stenosis and the size of the aortic root and ascending thoracic aorta [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-04900 | DOI: 10.5543/tkda.2018.04900

The association of severe mitral stenosis and the size of the aortic root and ascending thoracic aorta

Leili Pourafkari1, Aidin Baghbani-oskouei3, Naser Aslanabadi1, Elgar Enamzadeh1, Samad Ghaffari1, Rezvaniyeh Salehi1, Bahram Sohrabi1, Safa Savadi-oskouei1, Arezou Tajlil1, Nader D Nader2
1Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2Department of Anesthesiology, University at Buffalo, Buffalo, New York, USA
3Shahid Beheshti University of Medical Sciences, Tehran, Iran


OBJECTIVE
We aimed to examine the role of isolated rheumatic mitral stenosis (MS) on remodeling of the aorta at various levels.

METHODS
In this prospective study, patients undergoing transesophageal echocardiography for various indications were screened. Participants were classified into two groups according to the presence of mitral stenosis with a valve area ≤ 1.5 cm2. Factors associated with the index dimensions of aorta at levels of annulus, root, sinotubular junction (STJ), and the proximal ascending portion (5-cm from the annulus) were evaluated. Multivariate linear models were constructed including the factors that affect the size of the aorta at any of aforementioned levels. Pearson correlation test was used to investigate the association of mitral valve area, mitral valve gradient and dimensions of the aorta.

RESULTS
One hundred seventy-nine men and 354 women were enrolled. Eighty-four patients had MS (15.8%). Patients with MS were younger and less likely to have hypertension. In univariate analysis, patients with MS had smaller annulus and STJ (P=0.003 and P=0.043, respectively). In multivariate analysis MS was found to correlate with smaller indexed size of aortic annulus with a regression coefficient value of 0.541 (P=0.005).

CONCLUSION
Presence of significant stenosis at the level of mitral valve is associated with smaller diameter of aortic annulus. It is yet to be clarified whether this phenomenon occurs due to chronic long-standing low stroke volume or involvement of the aortic annulus in fibrotic process of mitral disease.

Keywords: mitral stenosis, ascending aorta, echocardiography, rheumatic heart disease, aortic annulus

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Corresponding Author: Nader D Nader, United States
© Copyright 2018 Archives of the Turkish Society of Cardiology
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