The association between severe mitral stenosis and the size of the aortic root and the ascending thoracic aorta [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2019; 47(1): 45-52 | DOI: 10.5543/tkda.2018.04900

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

Leili Pourafkari1, Aidin Baghbani-oskouei2, Naser Aslanabadi1, Elgar Enamzadeh1, Samad Ghaffari1, Rezvaniyeh Salehi1, Bahram Sohrabi1, Safa Savadi-oskouei1, Arezou Tajlil1, Nader D Nader3
1Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Department of Anesthesiology, University at Buffalo, Buffalo, New York, USA


OBJECTIVE
The aim of this study was to examine the role of isolated rheumatic mitral stenosis (MS) in remodeling of the aorta at various locations.

METHODS
In this prospective study, patients who were to undergo transesophageal echocardiography for various indications were screened. The study participants were classified into 2 groups according to the presence of MS with a valve area ≤1.5 cm2. Factors associated with the index dimensions of the aorta at the levels of the annulus, root, sinotubular junction (STJ), and the proximal ascending portion (5 cm from the annulus) were evaluated. Multivariate linear models were constructed including factors that affect the size of the aorta at any of the aforementioned levels. Pearson’s correlation coefficient was used to investigate the association between mitral valve area, mitral valve gradient, and dimensions of the aorta.

RESULTS
A total of 179 men and 354 women were enrolled. Eighty-four patients had MS (15.8%). The patients with MS were younger and less likely to have hypertension. In univariate analysis, patients with MS had a smaller annulus and STJ (p=0.003 and p=0.043, respectively). Multivariate analysis indicated that MS was correlated with a smaller indexed size of the aortic annulus, yielding a regression coefficient value of 0.541 (p=0.005).

CONCLUSION
The presence of significant stenosis at the level of the mitral valve is associated with a smaller diameter in the 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 the fibrotic process of mitral disease.

Keywords: Aortic annulus, ascending aorta, echocardiography; mitral stenosis; rheumatic heart disease.

How to cite this article
Leili Pourafkari, Aidin Baghbani-oskouei, Naser Aslanabadi, Elgar Enamzadeh, Samad Ghaffari, Rezvaniyeh Salehi, Bahram Sohrabi, Safa Savadi-oskouei, Arezou Tajlil, Nader D Nader. The association between severe mitral stenosis and the size of the aortic root and the ascending thoracic aorta. Turk Kardiyol Dern Ars. 2019; 47(1): 45-52

Corresponding Author: Nader D Nader, United States
© Copyright 2019 Archives of the Turkish Society of Cardiology
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