Клинические и морфологические признаки аномалий митрального комплекса
Аннотация
Митральный клапанный комплекс является многокомпонентной структурой, анатомически и функционально скоординированной, обеспечивающей нормальную деятельность левого желудочка (ЛЖ) и в целом сердца. Врожденные нарушения строения, количества, формы компонентов митрального комплекса могут протекать малосимптомно или вызывать гемодинамические нарушения, требующие хирургического лечения. Нередко клинические признаки аномалий митрального комплекса проявляются в виде митрального стеноза, недостаточности или сочетания стеноза с недостаточностью и служат основанием для неверного диагностического заключения. Распознавание морфологических признаков аномалий при эхокардиографическом исследовании предполагает знание возможных отклонений строения структур сердца, необходимых для выбора дальнейшей тактики наблюдения и лечения. В статье приведено описание нормальной анатомии митрального клапанного комплекса и аномалий фиброзного кольца, створок, папиллярных мышц и створочных хорд митрального клапанного
Ключевые слова
митральный клапанный комплекс,
аномалии,
диагностика,
клинические признаки,
морфологические признаки
Об авторах
Е. Л. Трисветова
УО Белорусский государственный медицинский университет
Беларусь
Беларусь
Трисветова Евгения Леонидовна — доктор медицинских наук, профессор 2-й кафедры внутренних болезней
Минск
О. А. Юдина
УО Белорусский государственный медицинский университет
Беларусь
Беларусь
Юдина Ольга Анатольевна — доктор медицинских наук, доцент кафедры патологической анатомии
Минск
Список литературы
1. Muresian H. The clinical anatomy of the mitral valve. Clin Anat. 2009;22:85-98. doi:10.1002/ca.20692.
2. Banerjee A, Kohl T, Silverman NH. Echocardiographic evaluation of congenital mitral valve anomalies in children. Am J Cardiol. 1995;76:1284-91.
3. Remenyi B, Gentles TL. Congenital mitral valve lesions: Correlation between morphology and imaging. Ann Pediatr Cardiol. 2012;5(1):3-12. doi:10.4103/0974-2069.93703.
4. Webb RH, Wilson NJ, Lennon DR, et al. Optimising echocardiographic screening for rheumatic heart disease in New Zealand: not all valve disease is rheumatic. Cardiol Young. 2011;21:436-43. doi:10.1017/S1047951111000266.
5. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890-900.
6. Ho SY. Anatomy of the mitral valve. Heart. 2002;88(Suppl IV):iv5-iv10. doi:10.1136/heart.88.suppl_4.iv5.
7. Muresian H, Diena M, Cerin G, et al. Mitral valve: New insights into the clinical anatomy. J Clin Med. 2006;1(4):80-7.
8. Liao J, Vesely I. A structural basis for the size-related mechanical properties of mitral valve chordae tendineae. J Biomech. 2003;36(8):1125-33.
9. Castillo JG, Solis J, Gonzalez-Pinto A, et al. Surgical Echocardiography of the Mitral Valve. Rev Esp Cardiol. 2011;64:1169-81 doi:10.1016/j.rec.2011.06.023.
10. Eriksson MJ, Bitkover CY, Omran AS, et al. Mitral annular disjunction in advanced myxomatous mitral valve disease: echocardiographic detection and surgical correction. J Am Soc Echocardiogr. 2005;18:1014-22. doi:10.1016/j.echo.2005.06.013.
11. Konda T, Tani T, Suganuma N, et al. The analysis of mitral annular disjunction detected by echocardiography and comparison with previously reported pathological data. J Echocardiogr. 2017;15(4):176-85. doi:10.1007/s12574-017-0349-1.
12. Gilles JM, Burkett G, Patel D. Obstetric management in 219 cases of infants with hypoplastic left heart syndrome. Am J Obstet Gynecol. 1999;181(1):226.
13. Caciolli S, Gelsomino S, Fradella G, et al. Severe hypoplasia of the posterior mitral leaflet. Ann Thorac Surg. 2008;86(6):1978-79. doi:10.1016/j.athoracsur.2008.05.055.
14. Pourafkari L, Baghbani‐Oskouei A, Toufan M, et al. Hypoplastic posterior mitral valve leaflet: A case report and review of the literature. Echocardiogr. 2018;35(7):1052-55. doi:10.1111/echo.13898
15. Tandon T, Patel A, Murray J, et al. Posterior mitral valve leaflet hypoplasia: an unusual presentation of mitral regurgitation. JACC. 2019;73(9):Suppl1.:2359. doi:10.1016/S07351097(19)32965-1.
16. Bhatia M, Kumar P, Martinelli SM. Surgical Echocardiography of the MV: Focus on 3D. Semin Cardiothorac Vasc Anesth. 2019 Mar;23(1):26-36. doi:10.1177/1089253218789409.
17. Purnode P, Rombaut E, Gerard M, et al. Double orifice mitral valve with flail leaflet: A transoesophageal echocardiographic examination. Eur J Echocardiogr. 2000;1:144-6. doi:10.1053/euje.2000.0015.
18. Bano-Rodrigo A, Van Praagh S, Trowitzsch E, et al. Doubleorifice mitral valve: a study of 27 postmortem cases with Congenital malformations of the mitral valve developmental, diagnostic and surgical considerations. Am J Cardiol.1988;61:152-60.
19. Trowitzsch E, Bano-Rodrigo A, Burger BM, et al. Two-dimensional echocardiographic findings in double orifice mitral valve. J Am Coll Cardiol. 1985;6(2):383-7.
20. Liu S, Ren W, Ma C, et al. Congenital Double-Orifice Mitral Valve in Asymptomatic Patients. Int Heart J. 2018;59(1):213-5. doi:10.1536/ihj.17-033.
21. Mychaskiw G, Sachdev V, Braden DA, et al. Supramitral ring: an unusual cause of congenital mitral stenosis. Case series and review. J Cardiovasc Surg. 2002;43(2):199-202.
22. Shone JD, Sellers RD, Anderson RC, et al. The developmental complex of ‘‘parachute mitral valve’’ supravalvular ring of left atrium, subaortic stenosis, and coarctation of aorta. Am J Cardiol. 1963;11:714-25.
23. Carpentier AF, Lessana A, Relland JY, et al. The “physio-ring”: an advanced concept in mitral valve annuloplasty. Ann Thorac Surg. 1995;60:1177-85.
24. Toscano A, Pasquini L, Iacobelli R, et al. Congenital supravalvular mitral ring: an underestimated anomaly. J Thorac Cardiovasc Surg. 2009;137(3):538-42. doi:10.1016/j.jtcvs.2008.08.023.
25. Collison SP, Kaushal SK, Dagar KS, et al. Supramitral ring: good prognosis in a subset of patients with congenital mitral stenosis. Ann Thorac Surg. 2006;81:997-1001.
26. Abadir S, Fouilloux V, Metras D, et al. Isolated cleft of the mitral valve: distinctive features and surgical management. Ann Thorac Surg. 2009;88:839-43. doi:10.1016/j.athoracsur.2009.06.004.
27. Van Praagh S, Porras D, Oppido G, et al. Cleft mitral valve without ostium primum defect: anatomic data and surgical considerations based on 41 cases. Ann Thorac Surg. 2003;75:1752-62.
28. Hammiri AE, Drighil A, Benhaourech S. Spectrum of cardiac lesions associated with Isolated Cleft Mitral Valve and their impact on therapeutic choices. Arq Bras Cardiol. 2016;106(5):367-72. doi:10.5935/abc.20160053.
29. Kent SM, Markwood TT, Vernalis MN, et al. Cleft posterior mitral valve leaflet associated with counterclockwise papillary muscle malrotation. J Am Soc Echocardiogr. 2001;14:3034. doi:10.1067/mje.2001.110140.
30. Narang A, Addetia K, Weinert L, et al. Diagnosis of Isolated Cleft Mitral Valve Using Three-Dimensional Echocardiography. J Am Soc Echocardiogr. 2018;31(11):1161-67. doi:10.1016/j.echo.2018.06.008.
31. Chachoua A, Abboub B, Chemti S, et al. Trileaflet mitral valve associated with a bicuspid aortic valve. J Card Cases. 2016;13:37-9. doi:10.1016/j.jccase.
32. Irwin RB, Macnab A, Schmitt M. Tri-leaflet mitral valve in combination with hypertrophic cardiomyopathy. Eur Heart J. 2011;32:534. doi:10.1093/eur-heartj/ehq380.
33. D’Ancona G, Neuhausen-Abramkina A, Atmowihardjo I, et al. Tri-leaflet mitral valve anatomy: a rare occurrence leading to severe mitral valve regurgitation. Eur Heart J. 2015;36(26):1697. doi:10.1093/eurheartj/ehv124
34. Kauss ML, Miranda W, Sinak LJ, et al. Quadricuspid mitral valve: a rare phenotype associated with hypertrophic cardiomyopathy. Eur Heart J. 2018;39(15):1280. doi:10.1093/eurheartj/ehx690.
35. Delling FN, Vasan RS. Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis. Circulation. 2014;129:2158-70. doi:10.1161/CIRCULATIONAHA.113.006702.
36. Sattur S, Bates S, Movahed MR. Prevalence of mitral valve prolapse and associated valvular regurgitations in healthy teenagers undergoing screening echocardiography. Exp Clin Cardiol. 2010;15:e13-5.
37. Freed LA, Levy D, Levine RA, et al. Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med. 1999;341:1-7.
38. Padang R, Bagnall RD, Semsarian C. Genetic basis of familial valvular heart disease. Circ Cardiovasc Genet. 2012;5(5):569-80. doi:10.1161/circgenetics.
39. Séguéla P-M, Houyel L, Acar P. Congenital malformations of the mitral valve Arc Cardiovasc Dis. 2011;104:465-79. doi:10.1016/j.acvd.2011.06.004.
40. Levine RA, Hagege AA, Judge DP, et al. Mitral valve disease-morphology and mechanisms. Nar Rev Cardiol. 2015;12(12):689-710. doi:10.1038/nrcardio.2015.161.
41. Rizzo S, Basso C, Lazzarini E, et al. TGF-beta1 pathway activation and adherens junction molecular pattern in nonsyndromic mitral valve prolapse. Cardiovasc Pathol. 2015;24(6):359-67. doi:10.1016/jcarpath.
42. Kyndt F, Gueffet JP, Probst V, et al. Mutations in the gene encoding Filamin A as a cause for familial cardiac valvular dystrophy. Circulation. 2007;115:40-9. doi:10.1161/CIRCULATIONAHA.106.622621.
43. Bernstein JA, Bernstein D, Hehr U, et al. Familial cardiac valvulopathy due to Filamin A mutation. Am J Med Genet A. 2011;155A:2236-41. doi:10.1002/ajmg.a.34132.
44. Tourneau T, Scouarnec S, Cueff C, et al. New insights into mitral valve dystrophy: a Filamin-A genotype–phenotype and outcome study. Tur Heart J. 2018;39(15):1269-77. doi:10.1093/eurheartj/ehx505.
45. Delling FN, Rong J, Larson MG, et al. Evolution of mitral valve prolapse: insights from the Framingham Heart Study. Circulation. 2016;133(17):1688-95. doi:10.1161/circulationaha.115.020621.
46. Boudoulas KD, Boudoulas H. Floppy mitral valve (FMV)/mitral valve prolapse (MVP) and the FMV/MVP syndrome: pathophysiologic mechanisms and pathogenesis of symptoms. Cardiology. 2013;126(2):69-80. doi:10.1159/000351094.
47. Mohan JC, Shukla M, Mohan V, et al. Spectrum of congenital mitral valve abnormalities associated with solitary undifferentiated papillary muscle in adults. Indian Heart J. 2016;68(5):639-45. doi:10.1016/j.ihj.2015.12.014.
48. Tandon R, Moller JH, Edwards J. E. Anomalies associated with the parachute mitral valve a pathologic analysis of 52 cases. Can J Cardiol. 1986;2:278-81.
49. Oosthoek PW, Wenink AC, Macedo AJ, et al. The parachute-like asymmetric mitral valve and its two papillary muscles. J Thorac Cardiovasc Surg. 1997;114:9-15. doi:10.1016/SOOO22-5223(97)70111-9.
50. Lopez-Pardo F, Urbano-Moral JA, González-Calle A, et al. Three-dimensional transesophageal echocardiography in the anatomical assessment of isolated parachute mitral valve in an adult patient. Echocardiogr. 2015;32(11):1732-35. doi:10.1111/echo.13003.
51. Rim Y, McPherson DD, Kim H. Effect of congenital anomalies of the papillary muscles on mitral valve function. J Med Biol Eng. 2015;35(1):104-12. doi:10.1007/s40846-015-0011-1.
52. Layman TE, Edwards JE. Anomalous mitral arcade: a type of congenital mitral insufficiency. Circulation. 1967;35(2):389-95.
53. Hakim FA, Krishnaswamy C, Mookadam F. Mitral arcade in adults — A systematic overview. Echocardiography. 2013;30(3):354-59. doi:10.1111/echo.12126.
54. Federici D, Palmerini E, Lisi M, et al. Congenital Mitral Disease: Anomalous Mitral Arcade in a Young Man. Ann Thoracic Surgery. 2010;89(2):629-31. doi:10.1016/j.athoracsur.2009.07.070.
55. Mitruka SN, Lamberti JJ. Congenital heart surgery nomenclature and database project: Mitral valve disease. Ann Thorac Surg. 2000;69(4 Suppl):S132-46. doi:10.1016/s00034975(99)01360-0.
56. Teo LL, Cannell T, Babu-Narayan SV, et al. Prevalence of associated cardiovascular abnormalities in 500 patients with aortic coarctation referred for cardiovascular magnetic resonance imaging to a tertiary center. Pediatric Cardiology. 2011;32(8):1120-7. doi:10.1007/s00246-011-9981-0.
57. van Rensburg A, Herbst P, Doubell A. A retrospective analysis of mitral valve pathology in the setting of bicuspid aortic valves. Echo Res Pract. 2017;4(2):21-8. doi:10.1530/ERP-17-0016.
При поддержке: Отсутствуют
Для цитирования:
Трисветова Е.Л., Юдина О.А. Клинические и морфологические признаки аномалий митрального комплекса. Российский кардиологический журнал. 2020;25(1):3357. https://doi.org/10.15829/1560-4071-2020-1-3357
For citation:
Trysvetava Е., Yudina O. Clinical and morphological features of malformations of the mitral valve complex. Russian Journal of Cardiology. 2020;25(1):3357. (In Russ.) https://doi.org/10.15829/1560-4071-2020-1-3357
Просмотров: 195
Послать статью по эл. почте 
