Document Detail

Impact of preserved myocardial contractile function in the segments attached to the papillary muscles on reduction in functional mitral regurgitation.
MedLine Citation:
PMID:  23167507     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Effectiveness of functional mitral regurgitation (FMR) in heart failure patients is of growing importance for patient prognosis. The purpose of this study was to investigate whether regional myocardial contractile function as assessed by tissue Doppler strain rate imaging can predict reduction in FMR caused by dobutamine.
METHODS: Fifty-one patients with depressed left ventricular (LV) ejection fraction (32 ± 9%) secondary to dilated cardiomyopathy and FMR underwent evaluation of effective regurgitant orifice (ERO) of FMR, mitral valve deformation, global LV remodeling, and regional myocardial contractile function assessed by longitudinal peak systolic strain rate (Ssr) in 6 mid-LV segments from standard apical views. We also determined the average Ssr of segments attached to the papillary muscles, that is, the inferior, inferolateral, and anterolateral segments (PM segments Ssr). Low-dose (10 μg/kg per minute) dobutamine-induced reduction in ERO was compared with baseline variables.
RESULTS: Baseline valve tenting was associated with dobutamine-induced reduction in ERO (r = -0.30, P < 0.05). Receiver operating characteristic curve analysis showed that baseline valve tenting, LV sphericity index, inferior Ssr, inferolateral Ssr, and PM segments Ssr were predictors of dobutamine-induced ≥30% reduction in ERO. Importantly, only PM segments Ssr predicted dobutamine-induced ≥20% reduction in valve tenting with area under the curve of 0.67 (P < 0.05).
CONCLUSIONS: Preserved myocardial contractile function in the segments attached to the PMs was associated with dobutamine-induced reduction in mitral valve tenting and FMR, suggesting that our findings are important for improvement in cardiac function and FMR with medical treatment.
Kazuhiro Tatsumi; Hidekazu Tanaka; Toshiya Kataoka; Kazuko Norisada; Tetsuari Onishi; Hiroya Kawai; Ken-ichi Hirata
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-11-20
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  30     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-12     Completed Date:  2013-08-06     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-54     Citation Subset:  IM    
Copyright Information:
© 2012, Wiley Periodicals, Inc.
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MeSH Terms
Echocardiography, Doppler, Color / methods*
Echocardiography, Stress / methods*
Follow-Up Studies
Mitral Valve Insufficiency / physiopathology*,  ultrasonography
Myocardial Contraction / physiology*
Papillary Muscles / physiopathology,  ultrasonography*
Severity of Illness Index
Ventricular Function, Left / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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