Abstract
Amaç: Mitral kapak hastalığının etyolojisinde çeşitli faktörler rol oynamaktadır. Mitral kapak hastalıklarında müdahalenin zamanı klinisyen için önemli bir problemdir. Müdahale kararı verilse bile kapak yapı ve morfolojisi seçilecek yöntemi etkilemektedir. Çalışmamızda mitral kapak hastalıklarında müdahalenin şeklini belirleyen en önemli faktörlerden biri olan kapak kalsifikasyonun derecesinin değerlendirilmesinde non-invazif bir yöntem olan Integrated Backscatter’in (IBS) geçerliliğini sınadık. Materyel ve metod: Bu amaçla çalışmaya mitral kapak replasmanı endikasyonu konulan 15 kadın, 5 erkek toplam 20 hasta alındı. Operasyon öncesi bütün hastalara standart transtorasik ekokardiyografi yapıldı. IBS ölçümleri parasternal uzun eksen, apikal dört boşluk, apikal iki boşluk pencerelerinden yapıldı. Her pencerede kapakta 5 noktadan IBS ölçümü yapılarak bulunan değerlerin ortalaması alındı. Kazanç etkisinden kurtulmak için kapak IBS değerlerinin interatrial septum ve sol atrial boşluk IBS değerleri toplamlarına oranı kullanıldı. Operasyonla çıkarılan kapaklardaki kalsiyum seviyesi atomik absorbsiyon yöntemi ile çalışıldı. Bulgular: Veriler ortalama ± standart sapma olarak ifade edildi. Gruplar arası farklılıklar Kruskal-Wallis ile test edildi. IBS değerleri ile kapak kalsiyum seviyesi arasındaki ilişki korelasyon analizi ile test edildi. Koralesyon analizinde mitral kapak kalsiyum konsantrasyonu ile IBS oranı arasında anlamlı ilişki gösterildi.(r: 0.7; p<0.05). Sonuç: Çalışmamızda IBS tekniğinin mitral kapak kalsiyum içeriğini tayin edebilen non-invazif, kantitatif bir yöntem olduğu gösterildi. Bu yöntem mitral kapak hastalıklarında müdahalenin şekli ve zamanlamasında yardımcı bir parametre olabilir.
Keywords
Integrated backscatter mitral kapak hastalığı. atomik absorbsiyon mitral valvular disease atomic absorbtion
References
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- Referans2. Bonow RO, Carabello B, De Leon AC, Edmunds LH, Fedderly BJ, Freed MD, et al. ACC/AHA Guidelines Fort he Management of Patients With Valvular Heart Disease. A report of American College of Cardiology/American Heart Association Task Force on Practice Guidelines( Committee on the management of patients with valvular heart disease.) J AmCollCardiol1998;32:1515-1588
- Referans3. Can İ, Oto A. Kapak hastalıklarında durum ve değişen epidemiyoloji. Türk Kardiyoloji Seminerleri 2004;4(1):11-29
- Referans4. Gök H (yazar). Klinik Kardiyoloji, Genişletilmiş ikinci baskı. Konya: Nobel Tıp Kitabevleri 2002;337-353.
- Referans5. Braunwald E. ValvularHeartDisease. In: Braunwald E(ed), HeartDisease A Textbook of CardiovascularMedicine 5th ed. Philadelphia: WB Saunders,1997;1007-1029.
- Referans6. Smiseth OA, Bjorherheim R, Nitler-Hauge S. Noninvasive assesment of valvular function. In:Crawford MH, Dimarco JP(eds) London: Mosby 2001;6(1,1)-6(1,5)
- Referans7. Rahimtoola SH, Durairaj A, Mehra A, Nuno I. Current evaluation and management of Patients With Mitral Stenosis. Circulation2002;106:1183-1188.
- Referans8. Wunderlich NC, Beigel R, Siegel RJ. Management of mitral stenosis using 2D and 3D echo-Doppler imaging. JACC Cardiovasc Imaging. 2013 Nov;6(11):1191-205.
- Referans9. Enriquez-Sarano M. Timing of mitral valvesurgery. Heart 2002;87.79-85.
- Referans10. Dinçer İ, Döven O, Candan İ, Mitral darlığı, Mitral Yetersizliği. İçinde: Candan İ,Oral D (yazarlar), Kardiyoloji. Ankara: Antıp 2002;832,881
- Referans11. Oh JK, Seward JB, Tajik AJ (eds). Valvular Heart Disease. In: TheEcho Manual, 2nd ed. Philadelphia: LippincottWilliams&Wilkins 1999;103-129
- Referans12. Report of theAmerican Society of Echocardiography Committee on nomenclature and standarts in two dimensionalechocardiography. Circulation1980;62:212-217
- Referans13. Hu R, Chen T.Leaning Too Much on the Power of ProximalI sovelocity Surface Area? Don't Forget the Volumetric Method for Quantifying Functional Mitral Regurgitation. J AmHeartAssoc. 2021 Jun;10(11):e021914. doi: 10.1161/JAHA.121.021914. Epub 2021 May 22
- Referans14. Lambert AS, Mitral regurgitation. In: Perrino AC, Reeves ST(eds). A Practical approach to Transesophageal Echocardiography. Philadelphia: LippincottWilliams&Wilkins 2003;133-142
- Referans15. Otto CM,ed.Textbook of clinical echocardiography,2nd ed. Philadelphia: WBSaunders 2000;249-285
- Referans16. Kirklin JW, Barrot-Boyes BG (eds). CardiacSurgery, 2nd ed.New York: Churchill Livingstone, 1993;438-442
- Referans17. Lima E.C, Barbosa F. Jr. Krug F.J, Silva M.M, Vale M.G.R. Comparision of ultrasound assisted extractions lurry sampling and microwave-assisted digestion for cadmium, copper, and lead determination in biologial and sediment samples by electrotermal atomic absorbtion spectrometry. J Anal At. Spectrom2000;15:995-1000
- Referans18. Barbosa F. Jr, Krug F.J, Taravers A. Copperdetermination in biological materials by ETAAS using W-Rhpermanentmodifier. Talanta, 2002;57:177-186
- Referans19. Lima E.C, Brasil J.L, Vaghetti J.C.P. Evaluation different permanent modifiers fort he determination of arsenic in environmental samples by electrothermal atomic absorbtion spectrometry. Talanta,2003;60:103-113
- Referans20. Tohno S, Moriwake Y, Tohno Y, Minami T, Nishiwaki F,Utsumi M, Yamada M. Age-relatedchanges of element contents in human mitral andtricuspidvalves. BiolTrace Elem Res1999;70(2):137-147
- Referans21. Durak I, Sahin A, Yurtaslani Z, Sonel A. Analysis of calcium, zinc, magnesium, ironandcoppercontent in myocardiumandstenotic mitral valves. Am J Cardiol.1989 Dec 1;64(19):1392-1394
- Referans22. Durak I, Akyol O, es MU, Canbolat O, Akpoyraz M. Element structure in stenotic mitral valves. Am J Cardiol. 1993;71(4):355
- Referans23. Lattanzi F, Picano E, Landini L, Mazzarisi A, Pelosi G, Benassi A, et al. Invivoidentification of mitral valve fibrosis and calcium by real-time quantitative ultrasonic analysis. Am J Cardiol.1990;65(5):355-359
- Referans24. Tuohinen SS, Skytta T , Huhtala H, Virtanen V , Kellokumpu-Lehtinen PL , Raatikainen P.Dynamic Integrated Back scatter Detects Radiotherapy-induced Cardiac Changes Better than Strain Analysis - A Prospective Three-yearStudy. Anticancer Res. 2022 May;42(5):2507-2517Changes Better than Strain Analysis - A Prospective Three-yearStudy.
- Referans25. Rigolin VH, Vonesh MJ, Ng KH, Roth SI, Sehgal R, McPherson DD, Mehlman DJ. Structural evaluation of porcine heart valve prostheses with radiofrequency ultrasound. CardiovascPathol. 2001;10(4):179-188
- Referans26. Klein AL, Murray RD, Black IW, et al. Integrated Backscatter for quantification left atrial spontenous echo contrast. J AmCollCardio l1996;28:222-231
- Referans27. Ito T, Suwa M, Kobashi A, Hatsumi Y, Nakamura T, et al. Integrated back scatter assesment of left atrial spontenouse chocontrast in chronic nonvalvuler atrial fibrillation: Relation with clinical and echocardiographic parameters. J AmSocEchocardiogr 2000;13(5):666-673
- Referans28. DiBello V, Talarico L, Picano E, Giorgi D, Bertini A, Paterni M, Giusti C. Increased myocardial echodensity in left ventriculer pressure and volüme overload in human aortic valvular disease: An ultrasonic tissue characterization study. J AmSoc Echocardiogr.1997;10(4):320-329
- Referans29. Onbaşılı A, Tekten T, Ceyhan C. Dilate Kardiyomyopati Hastalarında Ultrasonik Intergrated Back scatter Analizi: Sağlıklı Bireylerle Karşılaştırma. Ana Kar Der. 2002,2(1):4-11
- Referans30. Stefenelli T, Abela C, Frank H, Koller-Strametz J, Globits S, Bergler-Klein J, Niederle B. Cardiac abnormalities in patients with primary hiperparathyroidism: implications forfollow-up. J ClinEndocrinolMetab. 1997;82(1):106-112
- Referans31. Wei T, Zeng C, Chen F, Wang C, Chen L, et al. Influence of commissural calcification on the immediate outcomes of percutaneous balloon valvuloplasty. ActaCardiol 2003;58(5):411-415
- Referans32. Palacious IF. Farewelltosurgical mitral commisuratomy for many patients. Circulation. 1998;97:223-226
- Referans33. Nicolosi GL, Pugh DM, Dunn M. Sensitivity and spesificity of echocardiography in the assessment of valve calcification in mitral stenosis. AmHeart J. 1979;98(2):171-175
- Referans34. Zanolla L, Marino P, Nicolosi GL, Peranzoni PF, Poppi A. Two-dimensional echocardiographic evaluation of mitral valve calcification. Sensitivity and specificity. Chest.1982;82(2):154-157
- Referans35. Wong M, Tei C, Shah PM. Sensitivity and specificity of two-dimensional echocardiography in the detection of valvular calcification. Chest.1983;84(4):423-427
- Referans36. Abascal VM, Wilkins GT, O’Shea JP, Choong CY, Palacios IF, Thomas JD, Rosas E, Newel JB, Block PC, Weyman AE. Prediciton of succesful outcome in 130 patients under going percutaneous balloon mitral valvotomy. Circulation.1990;82(2):448-456
- Referans37. Mezilis NE, Salame MY, Oakley GD. Predicting mitral regurgitation following percutenous mitral valvotomy with the Inoue balloon: Comparising two echocardiographic system. Clin Cardiol.1999;22(7):453-458
- Referans38. Passeri JJ, Dal-Bianco JP .Percutaneous Balloon Mitral Valvuloplasty: Echocardiographic Eligibility and Procedural Guidance. IntervCardiolClin. 2018 Jul;7(3):405-413
- Referans39. Cimino S Guarracino F, Valenti VG, Sciarretta S, Miraldi F. Echocardiography and Correction of Mitral Regurgitation: An Unbreakable Link.Cardiology. 2020;145(2):110-120
- Referans40. Dattolo P, Ferdeghini EM, Morales MA, et al. Myocardial texture charecterization in uremics by ultrasonic video dansitometric analysis: A review. J Nephrol2003;16:635-640
- Referans41. DiBello V, Panichi V, Pedrinelli R, Giorgi D, Bianchi M, Bertini A, et al. Ultrasonic video densitometric analysis of myocardium in end-stage renal disease treated with haemodialysis. Nephrol Dial Transplant1999;14:2184-2191
Abstract
Objectives: A lot of factors play role in the etiology of mitral valvular disease. Timing and type of the intervention for mitral valve disease are difficult problems for clinicians. Albeit the decision of intervention such as surgery or percutenous balloon valvotomy is given, valvular structure and morphology have been affecting the type of the intervention. We tried integrated backscatter (IBS) method which measures tissue density non-invasively in evaluating of valvular calcification degree that is one of the most important factors affecting the type of intervention in mitral valvular disease. Methods: 20 patients, 15 female and 5 male, in whom indications of mitral valve replacement were present were included. Routine transthoracic two-dimensional echocardiography was performed to all patients preoperatively. Also integrated backscatter records were taken in apical four chambers, apical two chambers and parasternal long axis views. IBS measurements were taken from five points for each leaflet and averaged. This approach was repeated in each echocardiographic window. To get rid of gain effect, total average valvular IBS value was divided by average value of interatrial septum plus left atrial cavity IBS value. Calcium level in the excised mitral valve was studied with atomic absorption spectrofotometry method. Results: All data were expressed as mean ± standard deviation. Multiple group comparison was performed with Kruskal-Wallis test. Relationship between IBS value and valvular calcium level was tested with correlation analysis. Correlation analysis showed significant relationship between calcium level and IBS ratio (r:0.7; p<0.05). Conclusions: In our study, it was documented that integrated backscatter imaging method determines non-invasively mitral valvular calcium level. This method might play a role in the timing and selection of the type of intervention in mitral valvular disease.
References
- Referans1. Taşdemir O. Mitral kapak hastalarında cerrahi değerlendirme ve cerrahi yaklaşımlar T Klin Kardiyoloji 2002;15:99-110
- Referans2. Bonow RO, Carabello B, De Leon AC, Edmunds LH, Fedderly BJ, Freed MD, et al. ACC/AHA Guidelines Fort he Management of Patients With Valvular Heart Disease. A report of American College of Cardiology/American Heart Association Task Force on Practice Guidelines( Committee on the management of patients with valvular heart disease.) J AmCollCardiol1998;32:1515-1588
- Referans3. Can İ, Oto A. Kapak hastalıklarında durum ve değişen epidemiyoloji. Türk Kardiyoloji Seminerleri 2004;4(1):11-29
- Referans4. Gök H (yazar). Klinik Kardiyoloji, Genişletilmiş ikinci baskı. Konya: Nobel Tıp Kitabevleri 2002;337-353.
- Referans5. Braunwald E. ValvularHeartDisease. In: Braunwald E(ed), HeartDisease A Textbook of CardiovascularMedicine 5th ed. Philadelphia: WB Saunders,1997;1007-1029.
- Referans6. Smiseth OA, Bjorherheim R, Nitler-Hauge S. Noninvasive assesment of valvular function. In:Crawford MH, Dimarco JP(eds) London: Mosby 2001;6(1,1)-6(1,5)
- Referans7. Rahimtoola SH, Durairaj A, Mehra A, Nuno I. Current evaluation and management of Patients With Mitral Stenosis. Circulation2002;106:1183-1188.
- Referans8. Wunderlich NC, Beigel R, Siegel RJ. Management of mitral stenosis using 2D and 3D echo-Doppler imaging. JACC Cardiovasc Imaging. 2013 Nov;6(11):1191-205.
- Referans9. Enriquez-Sarano M. Timing of mitral valvesurgery. Heart 2002;87.79-85.
- Referans10. Dinçer İ, Döven O, Candan İ, Mitral darlığı, Mitral Yetersizliği. İçinde: Candan İ,Oral D (yazarlar), Kardiyoloji. Ankara: Antıp 2002;832,881
- Referans11. Oh JK, Seward JB, Tajik AJ (eds). Valvular Heart Disease. In: TheEcho Manual, 2nd ed. Philadelphia: LippincottWilliams&Wilkins 1999;103-129
- Referans12. Report of theAmerican Society of Echocardiography Committee on nomenclature and standarts in two dimensionalechocardiography. Circulation1980;62:212-217
- Referans13. Hu R, Chen T.Leaning Too Much on the Power of ProximalI sovelocity Surface Area? Don't Forget the Volumetric Method for Quantifying Functional Mitral Regurgitation. J AmHeartAssoc. 2021 Jun;10(11):e021914. doi: 10.1161/JAHA.121.021914. Epub 2021 May 22
- Referans14. Lambert AS, Mitral regurgitation. In: Perrino AC, Reeves ST(eds). A Practical approach to Transesophageal Echocardiography. Philadelphia: LippincottWilliams&Wilkins 2003;133-142
- Referans15. Otto CM,ed.Textbook of clinical echocardiography,2nd ed. Philadelphia: WBSaunders 2000;249-285
- Referans16. Kirklin JW, Barrot-Boyes BG (eds). CardiacSurgery, 2nd ed.New York: Churchill Livingstone, 1993;438-442
- Referans17. Lima E.C, Barbosa F. Jr. Krug F.J, Silva M.M, Vale M.G.R. Comparision of ultrasound assisted extractions lurry sampling and microwave-assisted digestion for cadmium, copper, and lead determination in biologial and sediment samples by electrotermal atomic absorbtion spectrometry. J Anal At. Spectrom2000;15:995-1000
- Referans18. Barbosa F. Jr, Krug F.J, Taravers A. Copperdetermination in biological materials by ETAAS using W-Rhpermanentmodifier. Talanta, 2002;57:177-186
- Referans19. Lima E.C, Brasil J.L, Vaghetti J.C.P. Evaluation different permanent modifiers fort he determination of arsenic in environmental samples by electrothermal atomic absorbtion spectrometry. Talanta,2003;60:103-113
- Referans20. Tohno S, Moriwake Y, Tohno Y, Minami T, Nishiwaki F,Utsumi M, Yamada M. Age-relatedchanges of element contents in human mitral andtricuspidvalves. BiolTrace Elem Res1999;70(2):137-147
- Referans21. Durak I, Sahin A, Yurtaslani Z, Sonel A. Analysis of calcium, zinc, magnesium, ironandcoppercontent in myocardiumandstenotic mitral valves. Am J Cardiol.1989 Dec 1;64(19):1392-1394
- Referans22. Durak I, Akyol O, es MU, Canbolat O, Akpoyraz M. Element structure in stenotic mitral valves. Am J Cardiol. 1993;71(4):355
- Referans23. Lattanzi F, Picano E, Landini L, Mazzarisi A, Pelosi G, Benassi A, et al. Invivoidentification of mitral valve fibrosis and calcium by real-time quantitative ultrasonic analysis. Am J Cardiol.1990;65(5):355-359
- Referans24. Tuohinen SS, Skytta T , Huhtala H, Virtanen V , Kellokumpu-Lehtinen PL , Raatikainen P.Dynamic Integrated Back scatter Detects Radiotherapy-induced Cardiac Changes Better than Strain Analysis - A Prospective Three-yearStudy. Anticancer Res. 2022 May;42(5):2507-2517Changes Better than Strain Analysis - A Prospective Three-yearStudy.
- Referans25. Rigolin VH, Vonesh MJ, Ng KH, Roth SI, Sehgal R, McPherson DD, Mehlman DJ. Structural evaluation of porcine heart valve prostheses with radiofrequency ultrasound. CardiovascPathol. 2001;10(4):179-188
- Referans26. Klein AL, Murray RD, Black IW, et al. Integrated Backscatter for quantification left atrial spontenous echo contrast. J AmCollCardio l1996;28:222-231
- Referans27. Ito T, Suwa M, Kobashi A, Hatsumi Y, Nakamura T, et al. Integrated back scatter assesment of left atrial spontenouse chocontrast in chronic nonvalvuler atrial fibrillation: Relation with clinical and echocardiographic parameters. J AmSocEchocardiogr 2000;13(5):666-673
- Referans28. DiBello V, Talarico L, Picano E, Giorgi D, Bertini A, Paterni M, Giusti C. Increased myocardial echodensity in left ventriculer pressure and volüme overload in human aortic valvular disease: An ultrasonic tissue characterization study. J AmSoc Echocardiogr.1997;10(4):320-329
- Referans29. Onbaşılı A, Tekten T, Ceyhan C. Dilate Kardiyomyopati Hastalarında Ultrasonik Intergrated Back scatter Analizi: Sağlıklı Bireylerle Karşılaştırma. Ana Kar Der. 2002,2(1):4-11
- Referans30. Stefenelli T, Abela C, Frank H, Koller-Strametz J, Globits S, Bergler-Klein J, Niederle B. Cardiac abnormalities in patients with primary hiperparathyroidism: implications forfollow-up. J ClinEndocrinolMetab. 1997;82(1):106-112
- Referans31. Wei T, Zeng C, Chen F, Wang C, Chen L, et al. Influence of commissural calcification on the immediate outcomes of percutaneous balloon valvuloplasty. ActaCardiol 2003;58(5):411-415
- Referans32. Palacious IF. Farewelltosurgical mitral commisuratomy for many patients. Circulation. 1998;97:223-226
- Referans33. Nicolosi GL, Pugh DM, Dunn M. Sensitivity and spesificity of echocardiography in the assessment of valve calcification in mitral stenosis. AmHeart J. 1979;98(2):171-175
- Referans34. Zanolla L, Marino P, Nicolosi GL, Peranzoni PF, Poppi A. Two-dimensional echocardiographic evaluation of mitral valve calcification. Sensitivity and specificity. Chest.1982;82(2):154-157
- Referans35. Wong M, Tei C, Shah PM. Sensitivity and specificity of two-dimensional echocardiography in the detection of valvular calcification. Chest.1983;84(4):423-427
- Referans36. Abascal VM, Wilkins GT, O’Shea JP, Choong CY, Palacios IF, Thomas JD, Rosas E, Newel JB, Block PC, Weyman AE. Prediciton of succesful outcome in 130 patients under going percutaneous balloon mitral valvotomy. Circulation.1990;82(2):448-456
- Referans37. Mezilis NE, Salame MY, Oakley GD. Predicting mitral regurgitation following percutenous mitral valvotomy with the Inoue balloon: Comparising two echocardiographic system. Clin Cardiol.1999;22(7):453-458
- Referans38. Passeri JJ, Dal-Bianco JP .Percutaneous Balloon Mitral Valvuloplasty: Echocardiographic Eligibility and Procedural Guidance. IntervCardiolClin. 2018 Jul;7(3):405-413
- Referans39. Cimino S Guarracino F, Valenti VG, Sciarretta S, Miraldi F. Echocardiography and Correction of Mitral Regurgitation: An Unbreakable Link.Cardiology. 2020;145(2):110-120
- Referans40. Dattolo P, Ferdeghini EM, Morales MA, et al. Myocardial texture charecterization in uremics by ultrasonic video dansitometric analysis: A review. J Nephrol2003;16:635-640
- Referans41. DiBello V, Panichi V, Pedrinelli R, Giorgi D, Bianchi M, Bertini A, et al. Ultrasonic video densitometric analysis of myocardium in end-stage renal disease treated with haemodialysis. Nephrol Dial Transplant1999;14:2184-2191
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Surgery |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 30, 2023 |
| Submission Date | February 12, 2023 |
| Published in Issue | Year 2023 Volume: 2 Issue: 1 |
